Deep phenotyping of upper limb sensorimotor recovery in Asian stroke survivors: Protocol for a longitudinal observational study

Background and Aims: Reduced upper limb use after stroke results from a combination of motor, sensory, and cognitive impairments. So far, their longitudinal evolution, interactions, and effect on the use of the upper limb and quality of life has not been comprehensively described. We designed a longitudinal observational study to gather a multi-modal database on the time-course of upper limb recovery in Asian adults after stroke, and characterize the longitudinal relationship between upper limb recovery, common post-stroke impairments, as well as quality of life. Here we present the study protocol and preliminary results. Methods: Up to 400 participants with stroke will be recruited at Tan Tock Seng Hospital in Singapore and tested at up to 8 assessment time points, from subacute stages until 3 years post-stroke. We will perform a battery of clinical and neurophysiological assessments to describe the impairments most likely to influence upper limb recovery. Further, we will gather digital health metrics from technology-based assessments to sensitively characterize technology-based assessments and daily life limb usage. Also, health-related quality of life will be described using questionnaires and semi-structured interviews. Results: Overall, this study will likely yield 1) a comprehensive documentation of upper limb recovery, 2) clinically important information on early prognostic factors for rehabilitation outcomes, and 3) identify different recovery profiles of subgroups of stroke survivors. Conclusions: This study is expected to provide evidence to inform clinical decision making in Asian stroke survivors and help establishing personalized therapy programs.