This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Goodwin, N. Articles by Sunderland, A. Search for Related Content PubMed PubMed Citation Articles by Goodwin, N. Articles by Sunderland, A. Social Bookmarking                   What's this?

Intensive, time-series measurement of upper limb recovery in the subacute phase following stroke

Nottingham City Hospital NHS Trust, University of Nottingham, Nottingham, UK

Alan Sunderland

The Division of Stroke Medicine, University of Nottingham, Nottingham, UK

Objectives: To discover if intensive monitoring of wrist extension would produce consistent recovery curves during the subacute period, and whether any impact of additional physiotherapy could be detected. We also investigated improved approaches to statistical analysis in single-case experiments.

Design: A randomized multiple-baseline experiment with very frequent assessment.

Setting: Stroke rehabilitation unit.

Subjects: Four patients with some active wrist movement less than seven weeks after stroke.

Interventions: Wrist extension was measured twice daily with an electrogoniometer for 3–4 weeks. Additional upper limb physiotherapy (15 minutes, twice per day) commenced after a randomly determined period.

Main outcome measures: Speed and range of wrist movement.

Results: A logarithmic function was fitted to the data to produce recovery curves. In all cases, active range and maximum velocity of wrist extension rose gradually over time. Mean variability in range was <5%, but with occasional outliers. Range of passive movement decreased in two cases in association with pain and increased tone. There were no large improvements coinciding with additional physiotherapy but autoregression analysis indicated statistically significant changes in three cases. A randomization test confirmed an increase in active range associated with additional physiotherapy.

Conclusions: Intensive electrogoniometry provided a detailed recovery pattern for each of these patients. The data were surprisingly consistent over time, showing that it is feasible to use a time-series approach to investigate subacute recovery. Changes associated with additional physiotherapy were observed on some measures, demonstrating the potential of this approach for exploratory evaluation of interventions.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				G. Alon, A. F. Levitt, and P. A. McCarthy Functional Electrical Stimulation Enhancement of Upper Extremity Functional Recovery During Stroke Rehabilitation: A Pilot Study Neurorehabil Neural Repair, May 1, 2007; 21(3): 207 - 215. [Abstract] [PDF]

				B. Kollen, I. van de Port, E. Lindeman, J. Twisk, and G. Kwakkel Predicting Improvement in Gait After Stroke: A Longitudinal Prospective Study Stroke, December 1, 2005; 36(12): 2676 - 2680. [Abstract] [Full Text] [PDF]

				T. Koyama, K. Matsumoto, T. Okuno, and K. Domen A new method for predicting functional recovery of stroke patients with hemiplegia: logarithmic modelling Clinical Rehabilitation, July 1, 2005; 19(7): 779 - 789. [Abstract] [PDF]