Arm Training in Standing After Stroke

Residual motor deficits are common after stroke and often have a negative impact on the performance of functional activities and overall quality of life. A frequently reported contribution to these functional limitations is an inability to incorporate the weaker arm and hand into daily activities. While rehabilitation interventions can improve arm functional capacity, these improvements often do not translate into increased real-world arm use which is often reduced after stroke.

The performance of skilled arm and hand movements in standing requires precise coordination between upper extremity movement and balance control. Many everyday functional tasks that require the arm are performed in standing (e.g. opening a door or meal preparation at the kitchen counter), however, training of arm function in rehabilitation is often done in sitting. An important rehabilitation approach may be to create a training environment that resembles the way the arm is used in everyday life (i.e. standing). This study will examine the feasibility of providing task-oriented, functional arm training in standing and during walking in individuals with motor deficits due to stroke.

Inclusion criteria

• At least 18 years old
• Had a stroke at least 6 months prior to enrollment
• Show evidence of continued arm and hand weakness
• Have some ability to move the arm and hand that is weaker from the stroke
• Be able to stand with minimal assistance or less without support of the weaker arm for at least 2 minutes
• Be able to follow two-step commands.

Exclusion criteria

• Acute medical issues that would interfere with participation
• Another neurologic diagnosis that may impact movement (e.g. Parkinson's Disease)
• Severe apraxia or hemispatial neglect
• Pain that interferes with arm movement or standing