Hostname: page-component-78c5997874-8bhkd Total loading time: 0 Render date: 2024-11-19T03:18:20.376Z Has data issue: false hasContentIssue false
  • English
  • Français

Trajectory of Motor Performance Over Twelve Months in Nigerian Stroke Survivors

Published online by Cambridge University Press:  25 April 2014

Grace Oluwatitofunmi Vincent-Onabajo ,
Talhatu Kolapo Hamzat  and
Mayowa Ojo Owolabi
Grace Oluwatitofunmi Vincent-Onabajo*
Affiliation:
Department of Medical Rehabilitation (Physiotherapy), College of Medical Sciences, University of Maiduguri, Borno State, Nigeria
Talhatu Kolapo Hamzat
Affiliation:
Department of Physiotherapy, College of Medicine, University of Ibadan, Oyo State, Nigeria
Mayowa Ojo Owolabi
Affiliation:
Department of Medicine, Neurology Unit, College of Medicine, University of Ibadan, Oyo State, Nigeria
*
Address for correspondence: Dr Grace Vincent-Onabajo, Department of Medical Rehabilitation (Physiotherapy), College of Medical Sciences, University of Maiduguri, Borno State, Nigeria. E-mail:[email protected]
Get access

Abstract

Objective: Submissions on recovery of post-stroke motor performance vary, especially in relation to increasing time after stroke. This study examined the trajectory of motor performance over the first 12 months after stroke.

Methods: Consecutive first-incidence stroke survivors (N = 83) were recruited within 1 month of onset from a tertiary health institution in Nigeria. Simplified Fugl Meyer scale (S-FM) was used to assess motor performance at monthly intervals. Changes in overall motor performance, and differences between the affected upper and lower extremities, were examined using Friedman's ANOVA and paired t-tests, respectively.

Results: Significant improvement in motor performance was observed across 12 months (p < .001), with the proportion of stroke survivors with severe impairment at onset (53.3%) decreasing to 20% by 12 months. Lower extremity motor performance scores were significantly higher than for the upper extremity from 1 to 12 months (p <.01 at 3, 4, 5, 6 and 12 months; and p < .05 at the remaining months).

Conclusions: The potential for long-term improvement in motor performance after stroke was observed, suggesting that this can be harnessed by long-term rehabilitation efforts. The comparatively poorer outcome in the upper extremity indicates the need for extra rehabilitation strategies to enhance upper-extremity motor recovery in the first year of stroke.

Keywords

motor performancestrokeNigeriaupper extremitylower extremity
Type
Articles
Information
Brain Impairment , Volume 15 , Issue 1 , May 2014 , pp. 43 - 50
Copyright
Copyright © Australasian Society for the Study of Brain Impairment 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Aziz, N.A., & Raymond, A.A. (2008). Managing further rehabilitation in the longer-term stroke patients in the community: a new approach. Medicine and Health, 3, 1–6.Google Scholar
Bonita, R., & Beaglehole, R. (1988). Recovery of motor function after stroke. Stroke, 19, 1497–1500.CrossRefGoogle ScholarPubMed
Desrosiers, J., Malouin, F., Bourbonnais, D., Richards, C.L., Rochette, A., & Bravo, G. (2003). Arm and leg impairments and disabilities after stroke rehabilitation: relation to handicap. Clinical Rehabilitation, 17, 666–673.Google Scholar
De Wit, L., Putman, K., Schuback, B., Komarek, A., Angst, F., Baert, I., . . . De Weerdt, W. (2007). Motor and functional recovery after stroke: a comparison of 4 European rehabilitation centers. Stroke, 38, 2101–2107.Google Scholar
Duncan, P.W., Goldstein, L.B., Horner, R.D., Landsman, P.B., Samsa, G.P., & Matchar, D.B. (1994). Similar motor recovery of upper and lower extremity after stroke. Stroke, 25, 1181–1188.CrossRefGoogle ScholarPubMed
Duncan, P.W., Goldstein, L.B., Matchar, D.B., Divine, G.W., & Feussner, J. (1992). Measurement of motor recovery after stroke. Outcome assessment and sample size requirements. Stroke, 23, 1084–1089.Google Scholar
Fedy, A., Carlier, R., Roby-Brami, A., Bussel, B., Cazalis, F., Pierot, L., . . . Maier, M.A. (2002). Longitudinal study of motor recovery after stroke recruitment and focusing brain activation. Stroke, 33, 1610–1617.Google Scholar
Ferrucci, L., Bandinelli, S., Guralnik, J.M., Lamponi, M., Bertini, C., Falchini, M., . . . Baroni, A. (1999). Recovery of functional status after stroke. A postrehabilitation follow-up study. Stroke, 24, 200–205.CrossRefGoogle Scholar
Feys, H.M., De Weerdt, W.J., Selz, B.E., Cox Steck, G.A., Spichiger, R., Vereek, L.E., . . . Hoydonck, G.A. (1998). Effect of a therapeutic intervention for the hemiplegic upper limb in the acute phase after stroke a single-blind, randomized, controlled multicenter trial. Stroke, 29, 785–792.Google Scholar
Fugl-Meyer, A.R., Jaasko, L., Leyman, I., Olsson, S., & Steglind, S. (1975). The post-stroke hemiplegic patient I: a method for evaluation of physical performance. Scandinavian Journal of Rehabilitation Medicine, 7, 13–31.CrossRefGoogle Scholar
Hamzat, T.K., & Peters, G.O. (2009). Motor function and Quality of Life among stroke survivors in Ibadan Nigeria: 6-month follow-up study. European Journal of Physical Rehabilitation and Medicine, 45, 179–183.Google Scholar
Higgins, J., Mayo, N.E., Desrosiers, J., Salbach, N.M., & Ahmed, S. (2003). Upper-limb function and recovery in the acute phase poststroke. Journal of Rehabilitation Research and Development, 42, 65–76.Google Scholar
Holm, S. (1979). A simple sequential rejective multiple test procedure. Scandinavian Journal of Statistics, 6, 65–70.Google Scholar
Horgan, N.F., O'Regan, M., Cunningham, C.J., & Finn, M. (2009). Recovery after stroke: a 1-year profile. Disability and Rehabilitation, 31, 831–839.CrossRefGoogle ScholarPubMed
Horner, R.D., Matchar, D.B., Divine, G.W., & Feussner, J.R. (1991). Racial variations in ischemic stroke-related physical and functional impairments. Stroke, 22, 1497–1501.Google Scholar
Horner, R.D., Swanson, J.W., Bosworth, H.B., & Matchar, D.B. (2003). Effects of race and poverty on the process and outcome of inpatient rehabilitation services among stroke patients. Stroke, 34, 1027–1031.Google Scholar
Hsieh, Y.W., Hsueh, I.-P., Chou, Y.-T., Sheu, C.-F., Hsieh, C.-L., & Kwakkel, G. (2007). Development and validation of a short form of the Fugl-Meyer Motor Scale in patients with stroke. Stroke, 38, 3052–3054.Google Scholar
Krakauer, J.W. (2005). Arm function after stroke: from physiology to recovery. Seminars in Neurology, 25, 384–395.Google Scholar
Kwakkel, G., & Kollen, B.J. (2013). Predicting activities after stroke: what is clinically meaningful? International Journal of Stroke, 8, 25–32.Google Scholar
Kwakkel, G., Kollen, B., & Twisk, J. (2006). Impact of time on improvement of outcome after stroke. Stroke, 37, 2348–2353.Google Scholar
Kwakkel, G., Kollen, B.J., & Wagenaar, R.C. (1999). Therapy impact on functional recovery in stroke rehabilitation: a critical review of the literature. Physiotherapy, 85, 377–391.Google Scholar
Lo, A.C., Guarino, P.D., Richards, L.G., Haselkorn, J.K., Wittenberg, G.F., Fererman, D.G., . . . Peduzzi, P. (2010). Robot-assisted therapy for long-term upper-limb impairment after stroke. New England Journal of Medicine, 362, 1772–1783.Google Scholar
Lum, P.S., Burgar, C.G., Shor, P.C., Majmundar, M., & van der Loos, M. (2002). Robot-assisted movement training compared with conventional therapy techniques for the rehabilitation of upper-limb motor function after stroke. Archives of Physical Medicine and Rehabilitation, 83, 952–959.Google Scholar
Owolabi, M.O., & Platz, T. (2008). Proposing the stroke levity scale: a valid, reliable, simple, and time-saving measure of stroke severity. European Journal of Neurology, 15, 627–633.Google Scholar
Patel, M.D., Tilling, K., Lawrence, E., Rudd, A.G., Wolfe, C.D.A., & McKevitt, C. (2006). Relationships between long-term stroke disability, handicap and health-related quality of life. Age and Ageing, 35, 273–279.Google Scholar
Platz, T., Eickhof, C., van Kaick, S., Engel, U., Pinkowski, C., Kalok, S., & Pause, M. (2005). Impairment-oriented training or Bobath therapy for severe arm paresis after stroke: a single-blind, multicentre randomized controlled trial. Clinical Rehabilitation, 19, 714–724.Google Scholar
Prabhakaran, S., Zarahn, E., Riley, C., Speizer, A., Chong, J.Y., Lazae, R.M., . . . Krakauer, J.W. (2008). Inter-individual variability in the capacity for motor recovery after ischemic stroke. Neurorehabilitation and Neural Repair, 22, 64–71.CrossRefGoogle ScholarPubMed
Rathore, S.S., Hinn, A.R., Cooper, L.S., Tyroler, H.A., & Rosamond, W.D. (2002). Characterization of incident stroke signs and symptoms: findings from the atherosclerosis risk in communities study. Stroke, 33, 2718–2721.Google Scholar
Sawaki, L., Butler, A.J., Leng, X., Wassenaar, P.A., Mohammad, Y.M., Blanton, S., . . . Wittenberg, G.F. (2008). Constraint-induced movement therapy results in increased motor map area in subjects 3 to 9 months after stroke. Neurorehabilitation and Neural Repair, 22, 505–513.Google Scholar
Shelton, N.A.P., & Redding, M.J. (2001). Effect of lesion location on upper limb motor recovery after stroke. Stroke, 32, 107–112.Google Scholar
Sonde, L., Fernaeus, S.E., Nilsson, C.G., & Viitanen, M. (1998). Stimulation with low frequency (1.7 Hz) transcutaneous electric nerve stimulation (low-TENS) increases motor function of the post-stroke paretic arm. Scandinavian Journal of Rehabilitation Medicine, 30, 95–99.Google Scholar
Wade, D.T., Langton-hewer, R., Wood, V.A., Skilbeck, C.E., & Ismail, H.M. (1983). The hemiplegic arm after stroke: measurement and recovery. Journal of Neurology, Neurosurgery and Psychiatry, 46, 521–524.CrossRefGoogle ScholarPubMed
Ward, N.S., & Cohen, L.G. (2004). Mechanism underlying recovery of motor function after stroke. Archives of Neurology, 61, 1844–1848.Google Scholar
Winstein, C.J., Rose, D.K., Tan, S.M., Lewthwaite, R., Chui, H.C., & Azen, S.P. (2004). A randomized controlled comparison of upper-extremity rehabilitation strategies in acute stroke: a pilot study of immediate and long-term outcomes. Archives of Physical Medicine and Rehabilitation, 85, 620–628.Google Scholar