Please use this identifier to cite or link to this item: http://bura.brunel.ac.uk/handle/2438/14616
Title: What is the longitudinal profile of impairments and can we predict difficulty caring for the profoundly-affected arm in the first year post-stroke?
Authors: Allison, R
Kilbride, C
Chynoweth, J
Creanor, S
Frampton, I
Marsden, J
Keywords: Stroke;Upper limb;Spasticity;Pain;Contracture
Issue Date: 1-Sep-2017
Publisher: Elsevier
Citation: Allison R, Kilbride C, Chynoweth J, Creanor S, Frampton I, Marsden J. What is the longitudinal profile of impairments and can we predict difficulty caring for the profoundly affected arm in the first year poststroke?. Archives of physical medicine and rehabilitation. 2018 Mar 1;99(3):433-42.
Abstract: Objective: To establish the longitudinal profile of impairments of body functions and activity limitations of the arm, and evaluate potential predictors of difficulty caring for the profoundly-affected arm post-stroke. Design: Prospective cohort study. Setting: Three UK stroke services. Participants: People unlikely to regain functional use of the arm (N=155) were recruited at 2-4 weeks post-stroke, and followed up at 3, 6 and 12 months. Potential predictors at baseline were hypertonicity, pain, motor control, mood, sensation/perception, age and stroke severity. Interventions: NA Main Outcome Measures: Difficulty caring for the arm (LASIS), pain, hypertonicity, range of movement, arm function and skin integrity. Multi-variable linear regression identified the best fitting model for predicting LASIS at 12 months. Results: One hundred and ten participants (71%) were reviewed at one year. There was a large variation in the profile of arm functions and activity limitations. Inability or severe difficulty caring for the arm affected 29% of participants. Hypertonicity developed in 77%, with severe hypertonicity present in 25%. Pain was reported by 65%, 94% developed shoulder contracture and 6% had macerated skin. Difficulty caring for the arm increased with age, greater level of hypertonicity and stroke classification; collectively these factors accounted for 33% of the variance in LASIS. Conclusions: At one year post-stroke, there was a high incidence of impairments of body functions and activity limitations in people with a profoundly-affected arm. Individual profiles were very variable and although some pre-disposing factors have been identified, it remains difficult to predict who is at greatest risk.
URI: http://bura.brunel.ac.uk/handle/2438/14616
ISSN: 0003-9993
Appears in Collections:Dept of Clinical Sciences Research Papers

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