Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
BMC Neurology
Published in: BMC Neurology 1/2011

Open Access 01-12-2011 | Study protocol

SALGOT - Stroke Arm Longitudinal study at the University of Gothenburg, prospective cohort study protocol

Authors: Margit Alt Murphy, Hanna C Persson, Anna Danielsson, Jurgen Broeren, Åsa Lundgren-Nilsson, Katharina S Sunnerhagen

Published in: BMC Neurology | Issue 1/2011

Login to get access

Abstract

Background

Recovery patterns of upper extremity motor function have been described in several longitudinal studies, but most of these studies have had selected samples, short follow up times or insufficient outcomes on motor function. The general understanding is that improvements in upper extremity occur mainly during the first month after the stroke incident and little if any, significant recovery can be gained after 3-6 months. The purpose of this study is to describe the recovery of upper extremity function longitudinally in a non-selected sample initially admitted to a stroke unit with first ever stroke, living in Gothenburg urban area.

Methods/Design

A sample of 120 participants with a first-ever stroke and impaired upper extremity function will be consecutively included from an acute stroke unit and followed longitudinally for one year. Assessments are performed at eight occasions: at day 3 and 10, week 3, 4 and 6, month 3, 6 and 12 after onset of stroke. The primary clinical outcome measures are Action Research Arm Test and Fugl-Meyer Assessment for Upper Extremity. As additional measures, two new computer based objective methods with kinematic analysis of arm movements are used. The ABILHAND questionnaire of manual ability, Stroke Impact Scale, grip strength, spasticity, pain, passive range of motion and cognitive function will be assessed as well. At one year follow up, two patient reported outcomes, Impact on Participation and Autonomy and EuroQol Quality of Life Scale, will be added to cover the status of participation and aspects of health related quality of life.

Discussion

This study comprises a non-selected population with first ever stroke and impaired arm function. Measurements are performed both using traditional clinical assessments as well as computer based measurement systems providing objective kinematic data. The ICF classification of functioning, disability and health is used as framework for the selection of assessment measures. The study design with several repeated measurements on motor function will give us more confident information about the recovery patterns after stroke. This knowledge is essential both for optimizing rehabilitation planning as well as providing important information to the patient about the recovery perspectives.

Trial registration

ClinicalTrials.gov: NCT01115348
Appendix
Available only for authorised users
Literature
1.
2.
Broeks JG, Lankhorst GJ, Rumping K, Prevo AJ: The long-term outcome of arm function after stroke: results of a follow-up study. Disabil Rehabil. 1999, 21 (8): 357-364. 10.1080/096382899297459.CrossRefPubMed
3.
Nakayama H, Jorgensen HS, Raaschou HO, Olsen TS: Recovery of upper extremity function in stroke patients: the Copenhagen Stroke Study. Arch Phys Med Rehabil. 1994, 75 (4): 394-398. 10.1016/0003-9993(94)90161-9.CrossRefPubMed
4.
Parker VM, Wade DT, Langton Hewer R: Loss of arm function after stroke: measurement, frequency, and recovery. Int Rehabil Med. 1986, 8 (2): 69-73.CrossRefPubMed
5.
Feys HM, De Weerdt WJ, Selz BE, Cox Steck GA, Spichiger R, Vereeck LE, Putman KD, Van Hoydonck GA: Effect of a therapeutic intervention for the hemiplegic upper limb in the acute phase after stroke: a single-blind, randomized, controlled multicenter trial. Stroke. 1998, 29 (4): 785-792.CrossRefPubMed
6.
Nichols-Larsen DS, Clark PC, Zeringue A, Greenspan A, Blanton S: Factors influencing stroke survivors' quality of life during subacute recovery. Stroke. 2005, 36 (7): 1480-1484. 10.1161/01.STR.0000170706.13595.4f.CrossRefPubMed
7.
Carr J, Shepherd RB: Neurological rehabilitation, optimizing motor performance. 1998, Oxford: Butterwrth, Heineman
8.
Kwakkel G, Wagenaar RC, Twisk JW, Lankhorst GJ, Koetsier JC: Intensity of leg and arm training after primary middle-cerebral-artery stroke: a randomised trial. Lancet. 1999, 354 (9174): 191-196. 10.1016/S0140-6736(98)09477-X.CrossRefPubMed
9.
Williams BK, Galea MP, Winter AT: What is the functional outcome for the upper limb after stroke?. Aust J Physiother. 2001, 47 (1): 19-27.CrossRefPubMed
10.
Kwakkel G, Kollen B, Lindeman E: Understanding the pattern of functional recovery after stroke: facts and theories. Restor Neurol Neurosci. 2004, 22 (3-5): 281-299.PubMed
11.
Dobkin BH: Confounders in rehabilitation trials of task-oriented training: lessons from the designs of the EXCITE and SCILT multicenter trials. Neurorehabil Neural Repair. 2007, 21 (1): 3-13. 10.1177/1545968306297329.CrossRefPubMedPubMedCentral
12.
Hendricks HT, van Limbeek J, Geurts AC, Zwarts MJ: Motor recovery after stroke: a systematic review of the literature. Arch Phys Med Rehabil. 2002, 83 (11): 1629-1637. 10.1053/apmr.2002.35473.CrossRefPubMed
13.
Katrak P, Bowring G, Conroy P, Chilvers M, Poulos R, McNeil D: Predicting upper limb recovery after stroke: the place of early shoulder and hand movement. Arch Phys Med Rehabil. 1998, 79 (7): 758-761. 10.1016/S0003-9993(98)90352-5.CrossRefPubMed
14.
Verheyden G, Nieuwboer A, De Wit L, Thijs V, Dobbelaere J, Devos H, Severijns D, Vanbeveren S, De Weerdt W: Time course of trunk, arm, leg, and functional recovery after ischemic stroke. Neurorehabil Neural Repair. 2008, 22 (2): 173-179.CrossRefPubMed
15.
Mirbagheri MM, Rymer WZ: Time-course of changes in arm impairment after stroke: variables predicting motor recovery over 12 months. Arch Phys Med Rehabil. 2008, 89 (8): 1507-1513. 10.1016/j.apmr.2008.02.017.CrossRefPubMed
16.
Duncan PW, Goldstein LB, Matchar D, Divine GW, Feussner J: Measurement of motor recovery after stroke. Outcome assessment and sample size requirements. Stroke. 1992, 23 (8): 1084-1089.CrossRefPubMed
17.
Welmer AK, Holmqvist LW, Sommerfeld DK: Limited fine hand use after stroke and its association with other disabilities. J Rehabil Med. 2008, 40 (8): 603-608. 10.2340/16501977-0218.CrossRefPubMed
18.
Lawrence ES, Coshall C, Dundas R, Stewart J, Rudd AG, Howard R, Wolfe CD: Estimates of the prevalence of acute stroke impairments and disability in a multiethnic population. Stroke. 2001, 32 (6): 1279-1284.CrossRefPubMed
19.
Mirbagheri MM, Tsao CC, Rymer WZ: Changes of elbow kinematics and kinetics during 1 year after stroke. Muscle Nerve. 2008, 37 (3): 387-395. 10.1002/mus.20965.CrossRefPubMed
20.
Wagner JM, Lang CE, Sahrmann SA, Edwards DF, Dromerick AW: Sensorimotor impairments and reaching performance in subjects with poststroke hemiparesis during the first few months of recovery. Phys Ther. 2007, 87 (6): 751-765. 10.2522/ptj.20060135.CrossRefPubMed
21.
Trombly CA, Wu CY: Effect of rehabilitation tasks on organization of movement after stroke. Am J Occup Ther. 1999, 53 (4): 333-344.CrossRefPubMed
22.
Murphy MA, Sunnerhagen KS, Johnels B, Willen C: Three-dimensional kinematic motion analysis of a daily activity drinking from a glass: a pilot study. J Neuroengineering Rehabil. 2006, 3: 18-10.1186/1743-0003-3-18.CrossRefPubMedCentral
23.
Murphy MA, Willén Carin, Sunnerhagen Katharina: Kinematic Variables Quantifying Upper-Extremity Performance After Stroke During Reaching and Drinking From a Glass. Neurorehabilitation and Neural Repair. 2010, 1-11,
24.
Crosbie JH, Lennon S, McNeill MD, McDonough SM: Virtual reality in the rehabilitation of the upper limb after stroke: the user's perspective. Cyberpsychol Behav. 2006, 9 (2): 137-141. 10.1089/cpb.2006.9.137.CrossRefPubMed
25.
Swapp D, Pawar V, Loscos C: Interaction with co-located haptic feedback in virtual reality. Virtual Reality. 2006, 10 (1): 24-30. 10.1007/s10055-006-0027-5.CrossRef
26.
Henderson A, Korner-Bitensky N, Levin M: Virtual reality in stroke rehabilitation: a systematic review of its effectiveness for upper limb motor recovery. Top Stroke Rehabil. 2007, 14 (2): 52-61. 10.1310/tsr1402-52.CrossRefPubMed
27.
Boian R, Sharma A, Han C, Merians A, Burdea G, Adamovich S, Recce M, Tremaine M, Poizner H: Virtual reality-based post-stroke hand rehabilitation. Stud Health Technol Inform. 2002, 85: 64-70.PubMed
28.
Viau A, Feldman AG, McFadyen BJ, Levin MF: Reaching in reality and virtual reality: a comparison of movement kinematics in healthy subjects and in adults with hemiparesis. J Neuroeng Rehabil. 2004, 1 (1): 11-10.1186/1743-0003-1-11.CrossRefPubMedPubMedCentral
29.
Broeren J, Claesson L, Goude D, Rydmark M, Sunnerhagen KS: Virtual rehabilitation in an activity centre for community-dwelling persons with stroke. The possibilities of 3-dimensional computer games. Cerebrovasc Dis. 2008, 26 (3): 289-296. 10.1159/000149576.CrossRefPubMed
30.
Broeren J, Rydmark M, Bjorkdahl A, Sunnerhagen KS: Assessment and training in a 3-dimensional virtual environment with haptics: a report on 5 cases of motor rehabilitation in the chronic stage after stroke. Neurorehabil Neural Repair. 2007, 21 (2): 180-189. 10.1177/1545968306290774.CrossRefPubMed
31.
Broeren J, Sunnerhagen KS, Rydmark M: A kinematic analysis of a haptic handheld stylus in a virtual environment: a study in healthy subjects. J Neuroeng Rehabil. 2007, 4: 13-10.1186/1743-0003-4-13.CrossRefPubMedPubMedCentral
32.
WHO: International classification of functioning, disability and health: ICF. 2001, Geneva: WHO Library Cataloguing-in-Publication Data
33.
Barkelius K, Johansson A, Korm K, Lindmark B: Reliabilitets- och validitetsprövning av Modifierad Motor Assessment Scale enligt Uppsala Akademiska Sjukhus -95. Nordisk Fysioterapi. 1997, 29: 161-165.
34.
Lyle RC: A performance test for assessment of upper limb function in physical rehabilitation treatment and research. Int J Rehabil Res. 1981, 4 (4): 483-492. 10.1097/00004356-198112000-00001.CrossRefPubMed
35.
Adams HP, Bendixen BH, Kappelle LJ, Biller J, Love BB, Gordon DL, Marsh EE: Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment. Stroke. 1993, 24 (1): 35-41.CrossRefPubMed
36.
Bamford J, Sandercock P, Dennis M, Burn J, Warlow C: Classification and natural history of clinically identifiable subtypes of cerebral infarction. Lancet. 1991, 337 (8756): 1521-1526. 10.1016/0140-6736(91)93206-O.CrossRefPubMed
37.
Sangha O, Stucki G, Liang MH, Fossel AH, Katz JN: The Self-Administered Comorbidity Questionnaire: a new method to assess comorbidity for clinical and health services research. Arthritis Rheum. 2003, 49 (2): 156-163. 10.1002/art.10993.CrossRefPubMed
38.
Denvall V, Elmstahl S, Prigatano GP: Replication and construct validation of the Barrow Neurological Institute Screen for Higher Cerebral Function with a Swedish population. J Rehabil Med. 2002, 34 (4): 153-157. 10.1080/16501970213231.CrossRefPubMed
39.
Grimby G: Physical activity and muscle training in the elderly. Acta Med Scand Suppl. 1986, 711: 233-237.PubMed
40.
Mattiasson-Nilo I, Sonn U, Johannesson K, Gosman-Hedstrom G, Persson GB, Grimby G: Domestic activities and walking in the elderly: evaluation from a 30-hour heart rate recording. Aging (Milano). 1990, 2 (2): 191-198.
41.
Fugl-Meyer AR, Jaasko L, Leyman I, Olsson S, Steglind S: The post-stroke hemiplegic patient. 1. a method for evaluation of physical performance. Scand J Rehabil Med. 1975, 7 (1): 13-31.PubMed
42.
Duncan PW, Propst M, Nelson SG: Reliability of the Fugl-Meyer assessment of sensorimotor recovery following cerebrovascular accident. Phys Ther. 1983, 63 (10): 1606-1610.PubMed
43.
van Wijck FM, Pandyan AD, Johnson GR, Barnes MP: Assessing motor deficits in neurological rehabilitation: patterns of instrument usage. Neurorehabil Neural Repair. 2001, 15 (1): 23-30. 10.1177/154596830101500104.CrossRefPubMed
44.
Lyle R: A performance test for assessment of upper limb function in physical rehabilitation treatment and research. Int J Rehabil Res. 1981, 4 (4): 483-492. 10.1097/00004356-198112000-00001.CrossRefPubMed
45.
Yozbatiran N, Der-Yeghiaian L, Cramer SC: A standardized approach to performing the action research arm test. Neurorehabil Neural Repair. 2008, 22 (1): 78-90.CrossRefPubMed
46.
Hsieh CL, Hsueh IP, Chiang FM, Lin PH: Inter-rater reliability and validity of the action research arm test in stroke patients. Age Ageing. 1998, 27 (2): 107-113. 10.1093/ageing/27.2.107.CrossRefPubMed
47.
van der Lee JH, Beckerman H, Lankhorst GJ, Bouter LM: The responsiveness of the Action Research Arm test and the Fugl-Meyer Assessment scale in chronic stroke patients. J Rehabil Med. 2001, 33 (3): 110-113. 10.1080/165019701750165916.CrossRefPubMed
48.
Van der Lee JH, De Groot V, Beckerman H, Wagenaar RC, Lankhorst GJ, Bouter LM: The intra- and interrater reliability of the action research arm test: a practical test of upper extremity function in patients with stroke. Arch Phys Med Rehabil. 2001, 82 (1): 14-19. 10.1053/apmr.2001.18668.CrossRefPubMed
49.
Bohannon RW, Smith MB: Interrater reliability of a modified Ashworth scale of muscle spasticity. Phys Ther. 1987, 67 (2): 206-207.PubMed
50.
Gregson JM, Leathley MJ, Moore AP, Smith TL, Sharma AK, Watkins CL: Reliability of measurements of muscle tone and muscle power in stroke patients. Age Ageing. 2000, 29 (3): 223-228. 10.1093/ageing/29.3.223.CrossRefPubMed
51.
Mathiowetz V, Kashman N, Volland G, Weber K, Dowe M, Rogers S: Grip and pinch strength: normative data for adults. Arch Phys Med Rehabil. 1985, 66 (2): 69-74.PubMed
52.
Mathiowetz V, Weber K, Volland G, Kashman N: Reliability and validity of grip and pinch strength evaluations. J Hand Surg Am. 1984, 9 (2): 222-226.CrossRefPubMed
53.
Murphy MA, Willen C, Sunnerhagen KS: Kinematic variables quantifying upper-extremity performance after stroke during reaching and drinking from a glass. Neurorehabil Neural Repair. 2011, 25 (1): 71-80. 10.1177/1545968310370748.CrossRef
54.
Murphy MA, Sunnerhagen KS, Johnels B, Willen C: Three-dimensional kinematic motion analysis of a daily activity drinking from a glass: a pilot study. J Neuroeng Rehabil. 2006, 3: 18-10.1186/1743-0003-3-18.CrossRefPubMedCentral
55.
Broeren J, Rydmark M, Sunnerhagen KS: Virtual reality and haptics as a training device for movement rehabilitation after stroke: a single-case study. Archives of physical medicine and rehabilitation. 2004, 85 (8): 1247-1250. 10.1016/j.apmr.2003.09.020.CrossRefPubMed
56.
Broeren J, Bjorkdahl A, Pascher R, Rydmark M: Virtual reality and haptics as an assessment device in the postacute phase after stroke. Cyberpsychol Behav. 2002, 5 (3): 207-211. 10.1089/109493102760147196.CrossRefPubMed
57.
Broeren J, Sunnerhagen KS, Rydmark M: A kinematic analysis of a haptic handheld stylus in a virtual environment: a study in healthy subjects. J Neuroengineering Rehabil. 2007, 4: 13-10.1186/1743-0003-4-13.CrossRefPubMedCentral
58.
Penta M, Tesio L, Arnould C, Zancan A, Thonnard JL: The ABILHAND questionnaire as a measure of manual ability in chronic stroke patients: Rasch-based validation and relationship to upper limb impairment. Stroke. 2001, 32 (7): 1627-1634.CrossRefPubMed
59.
Penta M, Thonnard JL, Tesio L: ABILHAND: a Rasch-built measure of manual ability. Arch Phys Med Rehabil. 1998, 79 (9): 1038-1042. 10.1016/S0003-9993(98)90167-8.CrossRefPubMed
60.
Gustafsson S, Sunnerhagen K, Dahlin-Ivanoff S: Occupational therapist's and patients's perception of ABILHAND, a new assessment tool for measuring manual ability. Scand J Occup Ther. 2004, 11: 107-117. 10.1080/11038120410020692.CrossRef
61.
Duncan PW, Wallace D, Lai SM, Johnson D, Embretson S, Laster LJ: The stroke impact scale version 2.0. Evaluation of reliability, validity, and sensitivity to change. Stroke. 1999, 30 (10): 2131-2140.CrossRefPubMed
62.
Duncan PW, Bode RK, Min Lai S, Perera S: Rasch analysis of a new stroke-specific outcome scale: the Stroke Impact Scale. Arch Phys Med Rehabil. 2003, 84 (7): 950-963. 10.1016/S0003-9993(03)00035-2.CrossRefPubMed
63.
Cardol M, de Haan RJ, de Jong BA, van den Bos GA, de Groot IJ: Psychometric properties of the Impact on Participation and Autonomy Questionnaire. Arch Phys Med Rehabil. 2001, 82 (2): 210-216. 10.1053/apmr.2001.18218.CrossRefPubMed
64.
Cardol M, de Haan RJ, van den Bos GA, de Jong BA, de Groot IJ: The development of a handicap assessment questionnaire: the Impact on Participation and Autonomy (IPA). Clin Rehabil. 1999, 13 (5): 411-419. 10.1191/026921599668601325.CrossRefPubMed
65.
Kersten P, Cardol M, George S, Ward C, Sibley A, White B: Validity of the impact on participation and autonomy questionnaire: a comparison between two countries. Disabil Rehabil. 2007, 29 (19): 1502-1509. 10.1080/09638280601030066.CrossRefPubMed
66.
Rabin R, de Charro F: EQ-5D: a measure of health status from the EuroQol Group. Ann Med. 2001, 33 (5): 337-343. 10.3109/07853890109002087.CrossRefPubMed
67.
Euroqol: Euro-Qol: a new facility for the measurement of health-related quality of life. Health Policy. 1990, 16: 199-208.CrossRef
68.
Rasch G: Probabilistic models for some intellegence and attainment tests. 1980, Chicago: Chicago University Press
Metadata
Title
SALGOT - Stroke Arm Longitudinal study at the University of Gothenburg, prospective cohort study protocol
Authors
Margit Alt Murphy
Hanna C Persson
Anna Danielsson
Jurgen Broeren
Åsa Lundgren-Nilsson
Katharina S Sunnerhagen
Publication date
01-12-2011
Publisher
BioMed Central
Published in
BMC Neurology / Issue 1/2011
Electronic ISSN: 1471-2377
DOI
https://doi.org/10.1186/1471-2377-11-56

Other articles of this Issue 1/2011

BMC Neurology 1/2011 Go to the issue

Research article

Chronic widespread musculoskeletal pain, fatigue, depression and disordered sleep in chronic post-SARS syndrome; a case-controlled study

Research article

Decreased CD8+T cell response to Epstein-Barr virus infected B cells in multiple sclerosis is not due to decreased HLA class I expression on B cells or monocytes

Case report

Parkinsonian phenotype in Machado-Joseph disease (MJD/SCA3): a two-case report

Debate

Controversies in Neurology: why monoamine oxidase B inhibitors could be a good choice for the initial treatment of Parkinson's disease

Research article

Clinical features of headache associated with mobile phone use: a cross-sectional study in university students

Research article

Molecular and biochemical characterisation of a novel mutation in POLGassociated with Alpers syndrome