Upper limb functional recovery in chronic stroke patients after COVID-19-interrupted rehabilitation: An observational study

Abstract

AbstractBackgroundUpper limb function of chronic stroke patients declined when outpatient rehabilitation was interrupted, and outings restricted, due to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. In this study, we investigated whether these patients recovered upper limb function after resumption of outpatient rehabilitation.MethodsIn this observational study, 43 chronic stroke hemiplegic patients with impaired upper extremity function were scored for limb function via Fugl-Meyer Assessment of the Upper Extremity (FMA-UE), Action Research Arm Test (ARAT) after a structured interview, evaluation, and intervention. Scores at 6 months and 3 months before and 3 months after rehabilitation interruption were examined retrospectively, and scores immediately after resumption of care and at 3 and 6 months after resumption of care were examined prospectively. The amount of change for each time period and an analysis of covariance was performed with time as a factor and the change in FMA-UE and ARAT scores as dependent variables and by setting statistical significance at 5%.ResultsTime of evaluation significantly impacted total, part C, and part D of FMA-UE as well as total, pinch, and gross movement of ARAT. Post-hoc tests showed that the magnitude of change in limb function scores from immediately after resumption of rehabilitation to 3 months after resumption was significantly higher than the change from 3 months before to immediately after interruption for total, and part D of FMA-UE, and grip, and gross movement of ARAT (p<0.05).ConclusionsThe results suggest that upper limb functional decline in chronic stroke patients, caused by the SARS-CoV-2 pandemic-related therapy interruption and outing restrictions, was resolved after approximately 3 months of resumption of rehabilitation therapy. Our data can serve as reference standards for planning and evaluating treatment for chronic stroke patients with impaired upper limb function due to inactivity.