Chapter One justified the need for research into methodology which can examine the upper limb stroke patients and older adults using portable kinematic recording software on the basis of the prevalence of stroke and aging and the potential importance of upper limb impairment as a predictor of recovery from stroke. Chapter Two reviewed the literature on methodologies which measured tracking in stroke patients and found that a wide range of methodologies were available but measurement metrics tended to focus on a small number of indices, mostly root mean square error, suggesting that measuring tracking using other indices might be informative. Chapter Three examined differences in tracking performance between stroke patients and older adults at a range of tracking speeds using a novel kinematic recording technology. The equipment appeared to be feasible for use in a community setting and found that older adults were less accurate, consistent and smooth compared to younger adults, and that accuracy was particularly affected by speed of trial. It was suggested that this interaction between speed and age may have been due to poorer feedback control mechanisms in older adults. Chapter Four looked at stroke patients compared to age-matched controls in tracking performance and found, contrary to the hypothesis, that stroke patients were more accurate, consistent and smooth with both the contralesional and ipsilesional hand; while there was no difference between the hands within stroke patients. Stroke patients may have outperformed controls due to qualitative differences in neural strategies for tracking control or the differences found may have related to methodological differences in collecting data. Chapter Five used the same stroke data to examine the relationship between tracking impairment, activity limitations and participation restrictions within the framework of the International Classification of Functioning, Disability and Health (ICF) (WHO, 2001). It was found that impairment of tracking consistency in the ipsilesional limb predicted participation restriction partially mediated by activity - 5 - limitation. It was argued that tracking in the “unimpaired limb” may be important for predicting participation restriction due to a potential mediating relationship with cognition. The study also suggested that the ipsilesional limb might have potential for rehabilitation of the contralesional limb. Chapter Six discussed the main findings of the thesis. Despite lack of sensitivity of tracking task to stroke impairment, the results of the thesis showed that measuring tracking in older adults and stroke patients provided important information about contralesional and ipsilesional hand function compared to age-matched controls and in relation to activity and participation after stroke. The methodology used may have the potential to examine other research questions which involve the measurement of upper limb kinematics after stroke.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:633269 |
| Date | January 2014 |
| Creators | Sheehan, Sinéad |
| Publisher | University of Aberdeen |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Source | http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=215169 |
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