Self-perceived upper extremity motor function predicts health-related quality of life in chronic stroke survivors

Abstract

Purpose

To examine whether the Upper Extremity Functional Index (UEFI) score independently contributes to the Stroke Impact Scale (SIS) score and quantified its relative contribution to SIS scores in chronic stroke survivors.

Materials and methods

A cross-sectional study in a university-based rehabilitation centre with people with chronic stroke (N = 95) aged ≥ 50 years. The outcome measures included paretic hand grip strength, Fugl–Meyer Upper Extremity Assessment (FMA-UE), Wolf Motor Function Test (WMFT), UEFI, and SIS.

Results

Correlation analysis revealed that paretic hand grip strength, FMA-UE, UEFI, and WMFT scores exhibited a significant moderate positive correlation with SIS scores (r = 0.544–0.687, p < 0.001). The results of a regression model indicated that after adjustment for demographic factors and stroke-related impairments, the UEFI scores remained independently associated with SIS scores, accounting for 18.8% of the variance. The entire model explained 60.3% of the variance in SIS scores.

Conclusions

Self-perceived UE motor function is a crucial component to be included in rehabilitation programmes aimed at enhancing quality of life and participation among chronic stroke survivors.

IMPLICATIONS FOR REHABILITATION

• Observation-based outcome measures, e.g., Fugl–Meyer Assessment for Upper Extremity (FMA-UE), Wolf Motor Function Test (WMFT) could not predict the health-related quality of life (Stroke Impact scale (SIS)) in chronic stroke survivors in our study, which was contradictory with current studies.

• A self-perceived outcome measure to evaluate upper extremity function (Upper Extremity Functional Index (UEFI)) could independently predict the health-related quality of life (SIS), accounting for 18.8% of the variance.

• Our study demonstrated that self-perceived UE motor function would be an important component to optimize the rehabilitation programmes aimed at enhancing quality of life and social participation among chronic stroke survivors.

Keywords:

• Upper limb
• social participation
• stroke

Acknowledgements

The authors would like to thank all the subjects for their support and participation.

Ethics approval

The ethical approval was obtained from the Departmental Research Committee of the Hong Kong Polytechnic University (Approval number: HSEARS20210110002).

Author contributions

S.S.M.N. conceived the original idea and T.W.L. planned the experiments. H.P., S.S.L.L., C.S.K.L., C.C.C.C., R.C.K.C., C W.K.L., W.W.L.N., M.W.S.T., and E.H. carried out the experiments, performed the analytic calculations and S.S.M.N., T.W.L., and J.W. supervised the project. H.P. wrote the manuscript. All authors discussed the results and contributed to the final manuscript.

Disclosure statement

The authors declared no potential conflicts of interests regarding to the research, authorship, and publication of this article.

Additional information

Funding

This study was supported by the Health and Medical Research Fund (17182001), Food and Health Bureau, Hong Kong SAR Government, awarded to Prof. Shamay S.M. Ng and her team.