Modeling Upper Limb Rehabilitation-Induced Recovery After Stroke: The Role of Attention as a Clinical Confounder
Rattachement africain : it, us, be. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
OBJECTIVE: People who have survived stroke may have motor and cognitive impairments. High dose of motor rehabilitation was found to provide clinically relevant improvement to upper limb (UL) motor function. Besides, mounting evidence suggests that clinical, neural, and neurophysiological features are associated with spontaneous recovery. However, the association between these features and rehabilitation-induced, rather than spontaneous, recovery has never been fully investigated. The objective was to explore the association between rehabilitation dose and UL motor outcome after stroke, as well as to identify which variables can be considered potential candidate predictors of motor recovery. METHODS: People who survived stroke were assessed before and after a period of rehabilitation using motor, cognitive, neuroanatomical, and neurophysiological measures. We investigated the association between dose of rehabilitation and UL response (ie, Fugl-Meyer Assessment for upper extremity [FMA-UE]), using ordinary least squares regression as the primary analysis. To obtain unbiased estimates, adjusting covariates were selected using a directed acyclic graph. RESULTS: Baseline FMA-UE was the only factor associated with motor recovery (b = 0.99; 95% CI = 0.83 to 1.15 points). Attention emerged as a confounder of the association between rehabilitation and final FMA-UE (b = 5.5; 95% CI = -0.8 to 11.9 points), influencing both rehabilitation and UL response. CONCLUSION: Preserved attention in people who have survived stroke might lead to greater UL motor recovery, albeit estimates have high levels of variability. Moreover, the increase in the dose of rehabilitation can lead to 5.5 points improvement on the FMA-UE, a nonsignificant but potentially meaningful finding. The approach described here discloses a new framework for investigating the effect of rehabilitation treatment as a potential driver of recovery. IMPACT: Attentional resources could play a key role in UL motor recovery. There is a potential association between amount of UL recovery and dose of rehabilitation delivered, needing further exploration. Preserved attention and rehabilitation dose are candidate predictors of UL motor recovery.
Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.
Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Modeling Upper Limb Rehabilitation-Induced Recovery After Stroke: The Role of Attention as a Clinical Confounder
- Date Crossref
- 10/10/2024
- Éditeur
- Oxford University Press (OUP)
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
-
IRCCS San Camillo Hospital pays non établi dans la noticeÉtablissement de santé
-
University of Milan Biometry and Epidemiology “G.A. Maccacaro” pays non établi dans la noticeUniversité ou école supérieure
-
Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Healthcare Professions Department pays non établi dans la noticeÉtablissement de santé
-
Zimmer Biomet (United States) pays non établi dans la noticeEntreprise
-
Don Carlo Gnocchi Foundation pays non établi dans la noticeOrganisation à but non lucratif
-
KU Leuven pays non établi dans la noticeUniversité ou école supérieure
-
University of Padua pays non établi dans la noticeUniversité ou école supérieure
-
Azienda USL di Bologna pays non établi dans la noticeÉtablissement de santé
-
University of Bologna pays non établi dans la noticeUniversité ou école supérieure
-
Department of Clinical Sciences and Community Health pays non établi dans la noticeÉtablissement de santé
-
Laboratory of Medical Statistics Biometry and Epidemiology "G.A. Maccacaro pays non établi dans la noticeStructure de recherche
-
Fondazione Don Gnocchi pays non établi dans la noticeInstitution
IRCCS San Camillo Hospital, Biometry and Epidemiology “G.A. Maccacaro” — University of Milan et Healthcare Professions Department — Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.