A Comparison of Proximal and Distal Upper Limb Impairment Patterns after Stroke

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2023-08-28

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Saudi Digital Library

Abstract

Stroke is a widespread and devastating disorder leading to significant morbidity and mortality worldwide. Upper limb impairment is a typical consequence of stroke, affecting both the proximal and distal areas of the arm. However, there is a lack of consensus on these deficits' severity and recovery patterns. This study will fill a research gap by examining intensive upper limb rehabilitation outcomes in chronic stroke patients. Also, the study aimed to find the distribution of distal and proximal impairments among chronic stroke patients who underwent an intensive rehabilitation program. Moreover, the study investigated the relationship between the distal-proximal ratio and the severity of the condition in individuals with chronic stroke. This study used a cross-sectional approach and analysed data from chronic stroke survivors who were assessed and received therapy at University College London's Queen Square Upper Limb neurorehabilitation program. The findings imply that the intensive intervention caused a significant change in upper limb function as measured by functional outcome measures in both the short and long term. Also, the findings revealed that the distribution of impairments was primarily distal, with a greater percentage of impairments identified in the wrist and hand regions than in the shoulder and elbow. Further, the study found a positive association between the distal-proximal ratio and functional outcome measure scores, revealing that larger distal-proximal ratios were associated with better functional outcomes. The improvement observed in this study is consistent with previous research that utilized similar treatment approaches for chronic stroke patients. Additional research is needed to investigate effective intervention protocols, long-term effects, and factors impacting rehabilitation efficacy in people with chronic stroke.

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Stroke, hemiparesis, upper limb, FMA-UL, proximal, distal, arm weakness, motor impairment, neural control, CST, CRST

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