UBC Theses and Dissertations
Upper limb use following stroke : from epidemiology to wearable sensors Simpson, Lisa
Stroke is a leading cause of disability worldwide. Upper limb impairments that lead to difficulties incorporating the arm into daily activities are particularly common. Facilitating upper limb recovery is an important and complex endeavor in stroke rehabilitation. Upper limb use in one’s own environment is a key marker of upper limb recovery and is a potential important target for treatment. Self-report measures of upper limb use and wearable sensors that provide interpretable feedback about upper limb activity may make an important contribution to our understanding and facilitation of upper limb recovery. This dissertation consists of four studies. The first study used screening data from a consecutive sample longitudinal study to explore an updated prevalence of early upper limb weakness after stroke. This study suggested that upper limb weakness prevalence may be lower in the post-reperfusion therapy era and provides information about the population who will likely have difficulties using their upper limb. The second study used a longitudinal design to explore the trajectory of upper limb use in the first-year post stroke. Information from this study may inform the timing of interventions aimed at increasing upper limb use and provides evidence supporting the responsiveness of a quick-to-administer self-report measure of use. The third study used a qualitative focus group design to explore clinicians’ perceptions of a wearable device that captures upper limb activity. This study found that clinicians’ support the development of these devices for use outside of therapy and highlighted some features that may increase their clinical uptake. The final study used a cross-sectional design to provide preliminary evidence that supports the ability of a new wearable device to capture functional hand activities after stroke. Together these studies advance our knowledge about an important aspect of upper limb recovery and informs the development of a clinical trial that uses feedback from a wearable device to facilitate greater upper limb use after stroke.
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