Upper-Limb Paresis Severity Is Associated With Practice Dosage During Task-Oriented Training in Subacute Stroke-An Exploratory Secondary Analysis.

Abstract

Intensive, high-repetition practice is one of the strategies incorporated into upper-limb task-oriented training (UL-TOT) to promote experience-dependent neural plasticity after stroke. Although a target of 300 repetitions during a one-hour UL-TOT session is feasible, considerable variability in the practice dosage achieved across individuals has been observed. Multiple factors may influence practice dosage during UL-TOT. Therefore, this exploratory secondary analysis aimed to examine factors associated with practice dosage during UL-TOT in individuals with stroke. This secondary analysis included data from 33 individuals with subacute stroke enrolled in a randomized controlled trial. Associations between age, sex, stroke type, lesion location and volume, poststroke duration, upper-limb paresis severity, spasticity severity, and depression severity (independent variables), and practice dosage (dependent variable) were analyzed using stepwise multiple linear regression. Among the variables examined, upper-limb paresis severity was the only factor retained in the final stepwise multiple linear regression model and was significantly associated with practice dosage within this dataset (β = 0.804; p < 0.001). The regression model was statistically significant and explained 63.4% of the variance in practice dosage (adjusted R2 = 0.634). Upper-limb paresis severity was the only factor significantly associated with practice dosage during therapist-guided UL-TOT in individuals with subacute stroke within this dataset. However, these findings should be interpreted with caution, given the small sample size and the exploratory nature of the analysis.