The post-stroke upper limb improvement effort survey (IMPETUS): a survey of individuals with chronic stroke

ABSTRACT

Background: There is a considerable literature on arm/hand dysfunction post stroke, but little information on the participants’ opinions about perceived and desired arm/hand strength, recovery, and function.

Objective: The objective of this study was to examine the perceptions of individuals with stroke about arm/hand function and training devices.

Methods: A 69-item survey was developed addressing: activity before and after stroke, involved arm/hand function, willingness to use a training device, and important device characteristics. The survey included items from the Hand Function and Strength Subscales of the Stroke Impact Scale (SIS). Face validity was established by physical therapists and individuals with stroke. The survey was administered via phone and online.

Results: 852 registry participants were recruited. Ninety-seven responded; 83 completed the survey. Subjects were 51 males, 31 females; mean age: 65 (25–95); meantime since stroke: 13 years (1–34; SD 6.678). There was a statistically significant difference between perceived and desired arm/hand strength, recovery, and function p<0.0001. Impairment factors, such as weakness and spasticity were greater barriers to recovery than socio-economic ones. Most participants (94%) were willing to use a device; functional gains during/following use were the most important characteristics.

Limitations: Participants had greater arm impairment and were more chronic than other studies.

Conclusions: Participants desired more arm/hand strength, function, and recovery that they perceived they had achieved. Impairment – level factors posed more barriers to arm recovery than socioeconomic ones. Most participants were interested in using arm/hand training devices; the most important device characteristic is functional gain.

KEYWORDS:

• Stroke
• arm function
• participatory research

Acknowledgments

The authors would like to acknowledge the Doctor of Physical Therapy Students who worked on this project, including; Jessica Minton, PT, DPT; Keely McNutt, PT, DPT; Annie Rockert, PT, DPT; Morgan Steele, PT, DPT; Emma Taylor, PT, DPT; and Kathryn Webb, PT, DPT; the Physical Therapists who provided feedback on the early review of the survey, and the individuals with stroke who helped review the survey and who participated in the study.

Author Contributions

Concept/idea/research design/data collection/writing: JE Sullivan, C Carmona, J Drogos and J Yao

Data analysis: J Yao

Disclosure of Interest

The authors report no conflict of interest.

Correction Statement

Presented at the American Physical Therapy Association Combined Sections Meeting in New Orleans, LA in February 2018.

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

The survey was administered by Research Electronic Data Capture (REDCap). REDCap is supported at the Feinberg School of Medicine by the Northwestern University Clinical and Translational Science Institute, Research reported in this publication was supported, in part, by the National Institutes of Health’s National Center for Advancing Translational Sciences, Grant Number [UL1TR001422]. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.