Quantifying Nonuse in Chronic Stroke Patients: A Study Into Paretic, Nonparetic, and Bimanual Upper-Limb Use in Daily Life

Michielsen, Marian E.; Selles, Ruud W.; Stam, Henk J.; Ribbers, Gerard M.; Bussmann, Johannes B.

doi:10.1016/j.apmr.2012.03.016

Cited by 139Stroke Rehabilitation and RecoverySpatial Neglect and Hemispheric DysfunctionCerebral Palsy and Movement Disorders

Quantifying Nonuse in Chronic Stroke Patients: A Study Into Paretic, Nonparetic, and Bimanual Upper-Limb Use in Daily Life

Michielsen, Marian E., Selles, Ruud W., Stam, Henk J., Ribbers, Gerard M., Bussmann, Johannes B.·2012·Archives of Physical Medicine and Rehabilitation

DOI 10.1016/j.apmr.2012.03.016

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Abstract

Objective To quantify uni- and bimanual upper-limb use in patients with chronic stroke in daily life compared with healthy controls.Design Cross-sectional observational study.Setting Outpatient rehabilitation center.Participants Patients with chronic stroke (n=38) and healthy controls (n=18).Intervention Not applicable.Main outcome measures Upper-limb use in daily life was measured with an accelerometry-based upper-limb activity monitor, an accelerometer based measurement device. Unimanual use of the paretic and the nonparetic side and bimanual upper-limb use were measured for a period of 24 hours. Outcomes were expressed in terms of both duration and intensity.Results Patients used their unaffected limb much more than their affected limb (5.3h vs 2.4h), while controls used both limbs a more equal amount of time (5.4h vs 5.1h). Patients used their paretic side less than controls used their nondominant side and their nonparetic side more than controls their dominant side. The intensity with which patients used their paretic side was lower than that with which controls used their nondominant side, while that of the nonparetic side was higher than that of the dominant side of controls. Finally, patients used their paretic side almost exclusively in bimanual activities. During bimanual activities, the intensity with which they used their affected side was much lower than that of the nonaffected side.Conclusion Our data show considerable nonuse of the paretic side, both in duration and in intensity, and both during unimanual and bimanual activities in patients with chronic stroke. Patients do compensate for this with increased use of the nonparetic side.

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Upper extremity activity measures derived from accelerometers discriminated well between persons with stroke and healthy controls.
“Upper extremity activity measures derived from accelerometers discriminated well between persons with stroke and healthy controls [41, 42, 44, 50] as well as between patients with different impairment levels [40, 41].”
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Authors: Michielsen, M. E., Selles, R. W., Stam, H. J., Ribbers, G. M., & Bussmann, J. B.
Affiliations: Erasmus MC (NL)
Corresponding author: Bussmann, Johannes B.
ORCID: Selles, Ruud W.
Stam, Henk J.
Ribbers, Gerard M.
Bussmann, Johannes B.
Venue: Archives of Physical Medicine and Rehabilitation
Publisher: Elsevier BV
Published: 2012-11
Volume: 93
Issue: 11
Pages: 1975-1981
ISSN: 0003-9993 (ISSN-L)
DOI: 10.1016/j.apmr.2012.03.016
OpenAlex: W2007880756
Cited by: 139
References: 26
Citations by year: 2026: 6 · 2025: 5 · 2024: 5 · 2023: 7 · 2022: 18 · 2021: 12 · 2020: 12 · 2019: 16 · 2018: 15 · 2017: 7 · 2016: 10 · 2015: 9 · 2014: 8 · 2013: 5 · 2012: 3
FWCI: 8.42
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Archives of Physical Medicine and Rehabilitation (publishedVersion)
PubMed (publishedVersion)
EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
Topics: Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
Life Sciences › Neuroscience › Cognitive Neuroscience › Spatial Neglect and Hemispheric Dysfunction
Health Sciences › Medicine › Psychiatry and Mental health › Cerebral Palsy and Movement Disorders
Keywords: chronic stroke, paretic limb, bimanual coordination, upper limb activity, limb dominance
MeSH terms: Stroke Rehabilitation, Activities of Daily Living, Adult, Chronic Disease, Cross-Sectional Studies, Disability Evaluation, Female, Humans, Male, Middle Aged, Motor Activity, Paresis, Posture, Rehabilitation Centers, Time Factors, Reproducibility of Results, Case-Control Studies, Monitoring, Ambulatory, Stroke, Upper Extremity, Accelerometry

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Quantifying Nonuse in Chronic Stroke Patients: A Study Into Paretic, Nonparetic, and Bimanual Upper-Limb Use in Daily Life

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