Ann Rehabil Med.  2020 Oct;44(5):362-369. 10.5535/arm.20060.

Motor Function in the Late Phase After Stroke: Stroke Survivors’ Perspective

Affiliations
  • 1Center for Brain Repair, Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
  • 2Center for Advanced Reconstruction of Extremities (CARE), Sahlgrenska University Hospital, Mölndal, Sweden
  • 3Florey Institute of Neuroscience and Mental Health, Melbourne, Australia
  • 4University of Newcastle, Newcastle, Australia
  • 5Department of Psychology, University of Gothenburg, Gothenburg, Sweden
  • 6Stroke Center West, Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
  • 7Centre for Rehab Innovations (CRI), University of Newcastle, Newcastle, Australia
  • 8Hunter Medical Research Institute, Newcastle, Australia
  • 9Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore

Abstract


Objective
To examine the association between observer-assessed functional status and perceived recovery in the late phase after stroke. The study also aimed to determine whether observer-assessed functional improvements as a result of horse-riding therapy (H-RT) are related to enhanced perception of stroke recovery.
Methods
This is a descriptive correlational study using data derived from a three-armed randomized controlled trial in which 123 individuals were enrolled, among whom 43 received H-RT for 12 weeks. The measures included the Modified Motor Assessment Scale, Berg Balance Scale, Timed Up and Go, timed 10-m walk, and perceived recovery from stroke indicated by item #9 in the Stroke Impact Scale (version 2.0). Spearman rank order correlation (rs) was used in the analyses.
Results
There were moderate to strong positive or negative correlations between all four observer-assessed motor variables and participants’ ratings of perceived late-phase stroke recovery at trial entrance, ranging from rs=-0.49 to rs=0.54 (p<0.001). The results of the correlational analyses of variable changes showed that, after the end of the H-RT intervention, both self-selected and fast gait speed improvement were significantly correlated with increments in self-rated stroke recovery (rs=-0.41, p=0.01 and rs=-0.38, p=0.02, respectively).
Conclusion
This study provided data supporting the association between individual ratings of self-perceived recovery after stroke and observer-assessed individual motor function. The results further demonstrate that enhancement in perceived stroke recovery after completing the intervention was associated with objectively measured gains in both self-selected and fast gait speed.

Keyword

Stroke; Recovery; Horseback riding therapies; Walking speed; Motor activity

Figure

  • Fig. 1. Scatter plots for the association between gains in self-selected gait speed (A) and fast gait speed (B), and increments in perceived stroke recovery after end of horse-riding therapy.


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