Caitlin A. Doman, Kimberly J. Waddell, Ryan R. Bailey, Jennifer L. Moore, Catherine E. Lang; Changes in Upper-Extremity Functional Capacity and Daily Performance During Outpatient Occupational Therapy for People With Stroke. Am J Occup Ther 2016;70(3):7003290040. https://doi.org/10.5014/ajot.2016.020891
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© 2021 American Occupational Therapy Association
OBJECTIVE. This study explored how upper-extremity (UE) functional capacity and daily performance change during the course of outpatient rehabilitation in people with stroke.
METHOD. Fifteen participants receiving outpatient occupational therapy services for UE paresis poststroke were enrolled. UE motor capacity was measured with the Action Research Arm Test (ARAT), and UE performance was measured using bilateral, wrist-worn accelerometers. Measurements were taken at or near the start of therapy, at every 10th visit or every 30 days throughout the duration of services, and at discharge.
RESULTS. Three patterns were observed: (1) increase in ARAT scores and more normalized accelerometry profiles, (2) increase in ARAT scores but no change in accelerometry profiles, and (3) no change in ARAT scores or in accelerometry profiles.
CONCLUSION. UE performance in daily life was highly variable, with inconsistencies between change in UE capacity and change in UE performance. UE capacity and performance are important constructs to assess separately during rehabilitation.
Changes in UE capacity measured in the clinic may or may not result in increased UE performance in daily life. UE capacity and performance are different constructs and need to be measured separately.
Accelerometry is one option to measure and track change in UE performance during rehabilitation.
The results from UE capacity and performance assessments, taken throughout the duration of outpatient occupational therapy services, can guide clinical decision making regarding the provision of services and selection of specific interventions.
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