Authors (including presenting author) :
Leung WHV(1), Lee MSC(1), Chan YMK(1), Sum CK(1), Chan KMH(2), Leung KK(2), Yu SKS(2), Tse MYM(3), Cheung RTF(3)
Affiliation :
(1) Department of Occupational Therapy, Queen Mary Hospital, (2) Department of Medicine, Queen Mary Hospital, (3) Division of Neurology, Department of Medicine, The University of Hong Kong , Queen Mary Hospital
Introduction :
Early rehabilitation based on neuro-rehabilitation principles contributes significantly to the optimization of functional outcomes and quality of life of stroke patients. Promoting upper limb (UL) use in acute stroke phase are crucial to influence neuroplasticity and maximize recovery. With service gap in upper limb training for acute stroke patients is identified, we have developed a structured program of Upper Limb TRaining in Acute Stroke (ULTRA-Stroke) in Queen Mary Hospital (QMH). Our program includes five training activity levels to accommodate UL/hand function with various structured training activities and Hospital Authority (HA) mobile application ‘HA Go’ training videos.
Objectives :
To study on the impact of the pilot ULTRA-Stroke program on UL and hand function of acute stroke patients.
Methodology :
One group pretest-posttest design was conducted at acute stroke unit (ASU) of QMH. Stroke patients with limited UL function, level 3 to 7, rated by the Hong Kong version of the Functional Test for the Hemiplegic Upper Extremity (FTHUE-HK) were recruited into the program. Power grip, pinch grip, Box and Block Test (BBT) and Stroke Upper Limb Capacity Scale (SULCS) were used to assess the grip and pinch strength, dexterity and UL capacity respectively. Paired t-test was used to analyze for the outcome measures.
Result & Outcome :
Sixteen patients (mean age 65.6 years, 63% men) in ASU were recruited into the program during September to December 2022. Average 6.3 treatment sessions were received by patients. Results showed significant differences in power grip (p<.001), lateral pinch (p<.005) and SULCS (p<.005) between the pretest and posttest assessments. Power grip was increased 3.12 Kgf (95% CI [-4.82, -1.41]), lateral pinch was increased 0.88 Kgf (95% CI [-1.42, -0.33]), and SULCS score was increased 1.06 (95% CI [-1.72, -0.40]), representing patients have shown increased grip strength, pinch strength and optimized paretic UL capacity after training.
ULTRA-Stroke as a pilot program made positive impact on promoting early UL and hand rehabilitation of stroke patients at acute stage that was worth further developing and exploring its efficacy. Besides, it encourages the use of the stroke-affected UL/hand in everyday activities and facilitates the transition to self-managed exercises in acute stroke phase of rehabilitation.
