Document Type : Original Articles

Authors

1 Rehabilitation Research Center, Department of Occupational Therapy. School of Rehabilitation Sciences, Iran University of Medical Sciences (IUMS), Tehran, Iran

2 Rehabilitation Research Center, Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran

3 Rehabilitation Research Center, Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Science (IUMS);Tehran, Iran

Abstract

Background: Pain in patients with stroke is one of the essential factors that can
influence upper-limb performance, and it is better to divide these people into
separate groups. The Adult-Assisting Hand Assessment (Ad-AHA) is a tool that
recently is being used in upper-limb performance evaluation among patients
with stroke. The present study aimed to evaluate the diagnostic accuracy of the
Ad-AHA among patients with chronic stroke who had pain to discriminate
between the high upper-limb performance group and the low upper-limb
performance group.
Methods: In this cross-sectional study, 51 patients (mean age±SD = 69.33±8.73)
with chronic stroke who had pain participated and were divided into two groups
of high (group 1) and low (group 2) upper-limb performance measured by
the Action Reach Arm Test. The best cutoff point between groups, sensitivity,
and specificity by receiver operating characteristic (ROC) for Ad-AHA was
calculated.
Results: A significant difference in the total score of Ad-AHA between the
high and low upper-limb performance groups was seen (P˂0.001). The best
cutoff point for the total score of Ad-AHA between stroke patients with high
and low performance in the upper-limb who had pain was 47 (sensitivity=95.45,
specificity=89.21).
Conclusion: The results of this study show that the Ad-AHA has high sensitivity
and specificity to discriminate between stroke patients with high and low
performance in upper-limb performance who had pain.

Keywords

  1. Virani SS, Alonso A, Aparicio HJ, Benjamin EJ, Bittencourt MS, Callaway CW, et al. Heart disease and stroke statistics—2021 update: A report from the American Heart Association. Circulation. 2021;143(8):e254-e743.
  2. Chen C-M, Tsai C-C, Chung C-Y, Chen C-L, Wu KP, Chen H-C. Potential predictors for health-related quality of life in stroke patients undergoing inpatient rehabilitation. Health Qual Life Outcomes. 2015;13(1):1-10.
  3. Miller EL, Murray L, Richards L, Zorowitz RD, Bakas T, Clark P, et al. Comprehensive overview of nursing and interdisciplinary rehabilitation care of the stroke patient: A scientific statement from the American Heart Association. Stroke. 2010;41(10):2402-48.
  4. Nakayama H, Jørgensen HS, Raaschou HO, Olsen TS. Recovery of upper extremity function in stroke patients: The Copenhagen Stroke Study. Arch Phys Med Rehabil. 1994;75(4):394-8.
  5. Mehdizadeh M, Mehraban AH, Zahediyannasab R. The effect of group-based occupational therapy on performance and satisfaction of stroke survivors: Pilot trail, neuro-occupational view. BCNS J. 2017;8(1):69 -76.
  6. Cacchio A, De Blasis E, De Blasis V, Santilli V, Spacca G. Mirror therapy in complex regional pain syndrome type 1 of the upper limb in stroke patients. Neurorehabil Neural Repair. 2009;23(8):792-9.
  7. Shaw LC, Price CI, van Wijck FM, Shackley P, Steen N, Barnes MP, et al. Botulinum Toxin for the Upper Limb after Stroke (BoTULS) Trial: Effect on impairment, activity limitation, and pain. Stroke. 2011;42(5):1371-9.
  8. Walsh K. Management of shoulder pain in patients with stroke. Postgrad Med J. 2001;77(912):645-9.
  9. Leijon G, Boivie J, Johansson I. Central post-stroke pain—neurological symptoms and pain characteristics. Pain. 1989;36(1):13-25.
  10. Krumlinde-Sundholm L, Eliasson A-C. Development of the Assisting Hand Assessment: A Rasch-built measure intended for children with unilateral upper limb impairments. Scand J Occup Ther. 2003;10(1):16-26.
  11. Krumlinde-Sundholm L, Lindkvist B, Plantin J, Hoare B. Development of the assisting hand assessment for adults following stroke: A Rasch-built bimanual performance measure. Disabil Rehabil. 2019;41(4):472-80.
  12. Van Gils A, Meyer S, Van Dijk M, Thijs L, Michielsen M, Lafosse C, et al. The Adult Assisting Hand Assessment Stroke: Psychometric Properties of an Observation-Based Bimanual Upper Limb Performance Measurement. Arch Phys Med Rehabil. 2018;99(12):2513-22.
  13. Investigators WMPP. The World Health Organization MONICA Project (monitoring trends and determinants in cardiovascular disease): A major international collaboration. J Clin Epidemiol. 1988;41(2):105-14.
  14. Dick J, Guiloff R, Stewart A, Blackstock J, Bielawska C, Paul E, et al. Mini-mental state examination in neurological patients. J Neurol Neurosurg Psychiatry. 1984;47(5):496-9.
  15. Hoonhorst MH, Nijland RH, Van Den Berg JS, Emmelot CH, Kollen BJ, Kwakkel G. How do Fugl-Meyer arm motor scores relate to dexterity according to the action research arm test at 6 months poststroke? Arch Phys Med Rehabil. 2015;96(10):1845-9.
  16. Yozbatiran N, Der-Yeghiaian L, Cramer SC. A standardized approach to performing the action research arm test. Neurorehabil Neural Repair. 2008;22(1):78-90.
  17. Saberi Z.S, Habibi S.A, Behzadipour S, Taghizadeh G. Diagnostic accuracy of Timed Up and Go test in patients with Parkinson's disease who had freezing of gait. Func Disabil J. 2019;2(1):157-63.
  18. Delpont B, Blanc C, Osseby G, Hervieu-Bègue M, Giroud M, Béjot Y. Pain after stroke: A review. Revue Neurologique. 2018;174(10):671-4.
  19. Poduri KR. Shoulder pain in stroke patients and its effects on rehabilitation. J Stroke Cerebrovasc Dis. 1993;3(4):261-6.