Grant: CIHR Fellowship

The lifetime risk of stroke is 1 in 5 after age 55 and 70% of these individuals will have difficulty using their arms and hands. Even though they have the ability, people often do not use their affected arm and hand when they are discharged from rehabilitation because they learn to compensate with the less affected arm. This is troubling as patients are often being discharged home in the first month or two after stroke when the greatest neural recovery is expected and not using their arm will limit their recovery. Furthermore, decreased arm use can lead to weakened muscles, pain, osteoporosis and decreased quality of life. Studies have shown that using pedometers to track walking steps can help people become more physically active. The aim of this study is to determine whether a treatment that utilizes an arm pedometer may increase stroke-affected arm use among people undergoing outpatient therapy. With help from engineers, we have developed a new arm pedometer that can track how much the arm and hand is used. Occupational therapists who treat upper limb dysfunction after stroke will determine how much patients in the study use their arm by asking them to wear the arm pedometer for one week at home. Patients will then be randomly assigned to 1 of 2 groups. One group will receive standard outpatient therapy and the other group will receive standard therapy plus the arm pedometer program. The pedometer group will be asked to increase their use at home by a certain amount each week and will be asked to create goals that outline the types of tasks they will perform with their stroke-affected arm. After 8 weeks, we will compare the arm movement, use and weekly pedometer readings between the 2 groups. Findings from this study will help us improve treatments for the stroke-affected arm and may reduce the harmful effects associated with not using the arm. These treatments may ultimately improve arm recovery and the quality of life for people who have had a stroke.