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Upper extremity impairment, activity limitation, and participation restriction in individuals with chronic stroke Harris, Jocelyn Ellen


The upper extremity is used in virtually every aspect of daily life whether in self-care, work, or recreational activities. Upper extremity impairment following stroke is common and thus factors contributing to its function (e.g., strength, sensation, tone, hand dominance) following stroke could critically impact independence in daily activities and quality of life. The purpose of this study was to determine the relationship between variables of upper extremity impairment and activity limitation (assessed by performance on measures of ADL) and participation restriction (assessed by measures of satisfaction and quality of life), and to determine the effect of hand dominance on impairment and activity in individuals with chronic stroke. Ninety-three community dwelling individuals with chronic stroke participated in a clinical assessment of upper extremity function. The results of this study revealed that variables of upper limb impairment particularly muscle weakness and severity of motor impairment, did contribute to activity limitation and participation restriction in individuals with chronic stroke. s Further, the results suggested that if the dominant hand (versus the non-dominant) was affected by the stroke, individuals incurred less impairment (strength, tone, and pain) but not activity limitation. It is suggested that clinicians working in stroke rehabilitation focus on strength training of the affected upper limb to minimize dependence in ADL and enhance community living. As well, clinicians need to consider whether the affected hand is dominant or nondominant. Our results suggest that the affected non-dominant hand has greater impairment (versus affected dominant) thus enforcing the use of the affected non-dominant hand may reduce musculoskeletal changes and impairment, thereby enhancing motor performance post stroke.

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