Program in Physical Therapy (K.J.W., C.E.L.), Brown School (R.G.T., D.H.J.), Psychological and Brain Sciences (M.JS.), and Program in Occupational Therapy and Department of Neurology (C.E.L.), Washington University, St Louis, Missouri.
J Neurol Phys Ther. 2019 Oct;43(4):197-203. doi: 10.1097/NPT.0000000000000287.
The recovery patterns of upper limb (UL) impairment after stroke are established. Psychosocial factors such as belief that paretic UL recovery is possible, confidence, and motivation to use the paretic UL in everyday tasks are unexplored early after stroke. The purpose of this exploratory study was to characterize belief, confidence, and motivation to use the paretic UL in daily life, and self-perceived barriers to UL recovery over the first 24 weeks after stroke.
This was a longitudinal cohort study (N = 30) with 8 assessment sessions over the first 24 weeks after stroke. Belief, confidence, and motivation to use the paretic UL and self-perceived barriers were quantified via survey and analyzed using descriptive statistics. Change in the number of self-perceived barriers between weeks 2 and 24 was tested using a paired-samples t test. The relationship between UL capacity, depressive symptomatology, cognition, and each psychosocial factor was examined using Spearman rank-order correlation analyses.
Twenty-two participants completed all study assessments. Belief, confidence, and motivation were high across the 24 weeks, with little variation. There was no difference between the average number of barriers from weeks 2 to 24. There was no relationship between the clinical measures and psychosocial factors at week 2, 12, or 24.
High levels of belief, confidence, and motivation appear consistent over the first 6 months after stroke. The lack of correlations between psychosocial factors and clinical measures suggests belief, confidence, and motivation may not be vulnerable to functional status early after stroke.Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1 available at: http://links.lww.com/JNPT/A283).
脑卒中后上肢（UL）功能障碍的恢复模式已确立。脑卒中后早期，信念、信心和使用瘫痪上肢完成日常任务的动机等心理社会因素尚未得到探索，这些因素与瘫痪上肢的恢复有关。本探索性研究的目的是描述脑卒中后 24 周内，对使用瘫痪上肢的信念、信心和动机，以及对上肢恢复的自我感知障碍。
这是一项纵向队列研究（N=30），在脑卒中后 24 周内进行了 8 次评估。通过问卷调查来量化对使用瘫痪上肢的信念、信心和动机以及自我感知障碍，并进行描述性统计分析。使用配对样本 t 检验来检验第 2 周到第 24 周之间自我感知障碍数量的变化。使用 Spearman 等级相关分析来检验 UL 能力、抑郁症状、认知与每个心理社会因素之间的关系。
22 名参与者完成了所有研究评估。在 24 周内，信念、信心和动机均较高，变化不大。第 2 周到第 24 周的平均障碍数量没有差异。在第 2、12 和 24 周时，临床指标与心理社会因素之间没有相关性。
在脑卒中后 6 个月内，信念、信心和动机似乎一直保持在较高水平。心理社会因素与临床指标之间缺乏相关性表明，信念、信心和动机在脑卒中后早期可能不受功能状态的影响。视频摘要可提供作者的更多见解（观看视频，请访问：http://links.lww.com/JNPT/A283）。
