Individuals' perception about upper limb influence on participation after stroke: an observational study

Background: Stroke can compromise upper limb performance and influence the individual's participation in real life situations. Objective: To investigate how components of body function and activity affect the individuals' self-perception of their participation after stroke. Methods: In this observational study, the International Classification of Functioning, Disability and Health was used as model. Body function was assessed by palmar grip and pinch strength; Ashworth modified scale; Fugl-Meyer scale; and Motor-Free Visual Perception Test. The Purdue Pegboard Test and the aiming movement performance measured the activity. Upper limb participation was analyzed by the Hand Function domain of the Stroke Impact Scale (SIS). Thirty-four individuals after chronic stroke were divided into two groups, according to their Hand function SIS scores (severe and non-severe). Differences between groups were analyzed. Relationships between individual variables and the SIS score were verified. A regression model was proposed. Results: Strength and the Fugl-Meyer scale score were greater for the non-severe group. Muscle tone was greater for the severe group only in the wrist flexors. None of the activity variables differed between groups. The upper limb Fugl-Meyer score was able to predict 79% of the individuals in SIS Hand Function groups. Conclusion: Sensory-motor impairment, as measured by the upper limb Fugl-Meyer scale, can explain the influence of the upper limbs on participation in the individuals' perception.