Grant: Project Grant

Every year, over 50,000 new strokes are reported in Canada. Recent advances in acute care have increased the likelihood of surviving a large stroke and have resulted in up to 30% of all stroke survivors living with severe upper limb disability. Stroke survivors with severe arm disability have the poorest prognosis, lowest health related quality of life, incur the greatest costs to the healthcare system and receive the least amount of intensive rehabilitation. While some people with severe disability show little recovery, others attain a substantial amount of functional recovery. This highlights a need to be able to identify people with severe upper limb disability who have the most potential to show recovery. Additionally, there is currently poor understanding of what an individual with stroke considers to be meaningful recovery. Thus, the main aims of the proposed research are to: 1) track individuals with severe upper limb disability across the first year post stroke to determine which factors best predict recovery of function, 2) establish a definition of meaningful recovery using data from stroke survivors themselves in combination with clinical and brain based measures, and 3) test a novel algorithm that predicts the degree of functional recovery. Determining reasons why someone with severe upper limb impairment achieves meaningful recovery after stroke is an important question; this information will help to develop novel interventions for the growing and under-served group of people living with severe upper limb disability. Also, understanding how recovery occurs in people with severe arm impairment will enable the appropriate delivery of individualized rehabilitation interventions and better outcomes for Canadians with stroke.