Hsieh YW, Lin KC, Wu CY, Lien HY, Chen JL, Chen CC, Chang WH. Predicting clinically significant changes in motor and functional outcomes after robot-assisted stroke rehabilitation.
Arch Phys Med Rehabil 2013;
95:316-21. [PMID:
24113336 DOI:
10.1016/j.apmr.2013.09.018]
[Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Revised: 09/12/2013] [Accepted: 09/19/2013] [Indexed: 11/27/2022]
Abstract
OBJECTIVE
To investigate the predictors of minimal clinically important changes on outcome measures after robot-assisted therapy (RT).
DESIGN
Observational cohort study.
SETTING
Outpatient rehabilitation clinics.
PARTICIPANTS
A cohort of outpatients with stroke (N=55).
INTERVENTIONS
Patients with stroke received RT for 90 to 105min/d, 5d/wk, for 4 weeks.
MAIN OUTCOME MEASURES
Outcome measures, including the Fugl-Meyer Assessment (FMA) and Motor Activity Log (MAL), were measured before and after the intervention. Potential predictors include age, sex, side of lesion, time since stroke onset, finger extension, Box and Block Test (BBT) score, and FMA distal score.
RESULTS
Statistical analysis showed that the BBT score (odds ratio[OR]=1.06; P=.04) was a significant predictor of clinically important changes in the FMA. Being a woman (OR=3.9; P=.05) and BBT score (OR=1.07; P=.02) were the 2 significant predictors of clinically significant changes in the MAL amount of use subscale. The BBT score was the significant predictor of an increased probability of achieving clinically important changes in the MAL quality of movement subscale (OR=1.07; P=.02). The R(2) values for the 3 logistic regression models were low (.114-.272).
CONCLUSIONS
The results revealed that patients with stroke who had greater manual dexterity measured by the BBT appear to have a higher probability of achieving clinically significant motor and functional outcomes after RT. Further studies are needed to evaluate other potential predictors to improve the models and validate the findings.
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