Factors Predicting the Use of Paralyzed Upper Limbs in the Daily Life of Patients with Acute Stroke

Abstract

Background and Purpose: In patients with stroke, predictors of the use of paralyzed upper limbs in each activity of daily life, including eating and toileting, are not clear. Therefore, we aimed to identify factors that predict the use of paralyzed upper limbs in specific activities of daily life in patients with acute stroke. Method: This prospective observational study enrolled 155 patients with acute stroke. We used the paralytic arm participation measure (PPM) to evaluate the use of the paralyzed upper limb in daily life. Eating and toileting were assessed at admission and discharge. Factors that predicted the use of the paralyzed upper limb at discharge were analyzed by binomial logistic regression analysis. Results: The predictors of the use of paralyzed upper limbs for eating at discharge were age [odds ratio (OR)=0.93, p=.011], paralysis of the dominant hand (OR=3.75, p=.044), and motor function of the paralyzed upper limb (OR=2.16, p<.001). For toileting, the predictors were motor function of the paralyzed upper limb (OR=1.75, p<.001), sensory function of the paralyzed upper limb (OR=1.66, p=.004), and muscle strength of the quadriceps on the non-paralyzed side (OR=3.65, p=.005). Conclusion: These identified predictors may provide clues to interventions promoting the use of paralyzed upper limbs in the daily life of hospitalized patients with acute stroke. Observation and evaluation of each activity by an occupational therapist using the PPM is potentially useful in encouraging patients to consciously use the paralyzed upper limbs in