400 Section - Occupational therapy promotes the use of the affected upper extremity in persons with acute stroke.

The use of the affected upper extremity (UE) is crucial for improving UE function in persons with stroke. This study aims to determine whether occupational therapy (OT) promotes the use of the affected UE in persons with acute stroke. It also seeks to establish a consensus on analyzing the triaxial accelerometer.

Design:

This study included 59 participants with stroke admitted to our hospital. At 2 weeks after onset, a triaxial accelerometer was worn on the trunk and both wrists for 24 hours. Clinical assessments included the Fugl-Meyer Assessment UE Score, the Action Research Arm Test, and the Motor Activity Log. For statistical analysis, accelerometer data were used to calculate the activity level of the affected UE, the magnitude ratio, delta counts, activity time of the affected UE, and the use ratio. Correlations with clinical assessments were tested using Spearman's rank correlation coefficient. For participants receiving physical therapy (PT) and OT at 2 weeks after onset, the use ratio and physical activity time were compared across three periods (24 hours, during PT, and during OT) using the Friedman test and the Bonferroni post-hoc test.

Results:

Among the accelerometer data, the use ratio showed the highest correlation with clinical UE assessment (r=0.77–0.85). Fifty participants received both PT and OT at 2 weeks after onset. The median use ratio was 0.60 over 24 hours, 0.85 during PT, and 1.32 during OT (p< 0.001, OT >PT >24 hours). Physical activity time was 78.1 minutes (5.4%) over 24 hours, 7.7 minutes (19.7%) during PT, and 2.9 minutes (7.3%) during OT (p< 0.001, PT >OT >24 hours).

Conclusion: Occupational therapy promotes the use of the affected UE in persons with acute stroke. Furthermore, the use ratio is an excellent method for quantifying UE activity levels. Future analyses should also consider specificity based on lesion location and other factors.