Document Type : Original Articles
Rehabilitation Research Center, Department of Occupational Therapy. School of Rehabilitation Sciences, Iran University of Medical Sciences (IUMS), Tehran, Iran
Rehabilitation Research Center, Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
Rehabilitation Research Center, Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Science (IUMS);Tehran, Iran
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
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
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,
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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- Walsh K. Management of shoulder pain in patients with stroke. Postgrad Med J. 2001;77(912):645-9.
- Leijon G, Boivie J, Johansson I. Central post-stroke pain—neurological symptoms and pain characteristics. Pain. 1989;36(1):13-25.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- Poduri KR. Shoulder pain in stroke patients and its effects on rehabilitation. J Stroke Cerebrovasc Dis. 1993;3(4):261-6.