2023 年 19 巻 1 号 p. 68-76
Background and Purpose: We introduced an intervention that aimed to improve upper limb use in daily life using Aid for Decision-making in Occupation Choice for Hand (ADOC-H), a monitoring and problem-solving technique, in addition to conventional occupational therapy for hospitalized patients with acute stroke. This pilot study examined the effectiveness of this intervention to improve paralyzed upper limb use in daily life and their motor function.
Methods: This comparative study included 28 patients with acute stroke who underwent an intervention based on the ADOC-H process (ADOC-H group) and 155 participants from a previous study (control group). The paralytic arm participation measure (PPM; scores for eating and toileting items) was used to evaluate upper limb use in daily life, and the Stroke Impairment Assessment Set (SIAS; knee mouth [K-M] and finger flexion [F-F] tests) was used to evaluate upper limb motor function. The amount of change in these evaluations was compared between the two groups.
Results: Using propensity score matching, 21 participants were allocated to each group. Comparing the two groups, significant improvements were observed in the ADOC-H group for all items, as shown by the scores for PPM total (P = 0.005, r = 0.43), eating (P = 0.035, r = 0.32), toileting (P = 0.004, r = 0.44), upper limb motor function (P = 0.001, r = 0.52), K-M (P = 0.014, r = 0.38), and F-F (P = 0.002, r = 0.48).
Conclusion: This intervention process may be effective for improving the frequency of paralyzed upper limb use and upper limb motor function of the paralyzed upper limbs in patients with acute stroke.
