Deep Phenotyping of Upper Limb Sensorimotor Recovery in Asian Stroke Survivors: A Study Protocol

Research Objectives

Study protocol for gathering a rich database on the time-course of upper limb recovery in a representative stroke cohort of Asian adults. Technology-assisted metrics will be combined with clinical scores to investigate the longitudinal relationship between upper limb recovery and functional independence in daily life/health-related quality of life.

Design

A pragmatic, longitudinal, observational study. Participants with stroke will be assessed at up to eight assessment time points, from admission to inpatient rehabilitation until three years post-stroke. We will perform a battery of standardized clinical outcomes and neurophysiological assessments to describe the impairments most likely to influence upper limb recovery. Further, we will gather sensorimotor and arm usage metrics from technology-based assessments to sensitively characterize motor and sensory impairments and daily life upper limb usage. Health-related quality of life will be explored using questionnaires and semi-structured interviews. This approach allows investigation of the links between various aspects.

Setting

Tertiary rehabilitation center and clinic in Singapore.

Participants

Up to 400 Asian individuals with first-ever stroke, with upper limb impairment within eight weeks of rehabilitation admission.

Interventions

Not applicable.

Main Outcome Measures

The primary clinical outcome measures are the Fugl-Meyer Assessment of the Upper Extremity, Action Research Arm Test, and EQ-5D. The technology-aided assessments include wearable sensors, the Virtual Peg Insertion Test, and ETH Motor Impairment and Kinesthetic Evaluation. The neurophysiological outcome is motor evoked potentials.

Results

Overall, this study will likely yield 1) a comprehensive description 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 establish personalized therapy programs.