Prevalence of Postural Patterns of Upper Extremity.
Condition: Spasticity as Sequela of Stroke; Stroke; Upper Extremity Paresis
MeSH terms: Muscle Spasticity; Stroke; Paresis
Study type: Observational

Summary: 
      A high number of patient with stroke develops spasticity of the upper extremity, this
      clinical sign of damage of 1 motoneuro (MN), causes postures and patterns of abnormal
      movement, due to the hyperexcitability of the MN and the rheological alterations that occur
      in the affected muscles. These alterations limit the use of upper extremity, restricting its
      use in functional activities and affecting the quality of life and social participation of
      the users. During the last few years the classification of the Hefter patterns for spasticity
      of the upper limb was created, with the end of having a common language and orienting the
      current therapeutic strategies oriented towards the arm.

      Objective: To determine the prevalence of patterns and their impact on the quality of life of
      patients after a stroke.

      Material and method: Descriptive design of cross section, the sample will be composed of 600
      people who attend integral rehabilitation center of regions V, VIII, IX and X in Chile, that
      meet the inclusion criteria and sign the informed consent. The study will include a
      measurement made by a trained professional from each participating center using a
      registration form, the FIM scale and the Barthel index, to assess quality of life.

      Results: It will be analyzed with the SPSS software through descriptive and inferential
      statistics considering the nature of the variables, all the analyzes will consider as
      statistically significant the results with p values less than or equal to 0.05. Depending on
      the interval or ordinal level of the measurements, the coefficients r of Pearson and rho of
      Spearman will be used to calculate the correlations.

      Applicability: The results will determine the prevalence in this geographical sector,
      disseminate this classification and promote the use of a common language among professionals
      to enhance their daily work. In addition, it will allow to determine how the affectation of
      the upper extremity through the identification of a certain pattern alters the quality of
      life of the patient. This new information can be a fundamental input in the generation of
      future studies that seek to guide in relation to the use of therapeutic strategies in these
      people.
    

Detailed description: 
      The impact generated by spasticity in the performance of functional activities in post-stroke
      patients is undeniable. Given the above, it is essential to evaluate this construct,
      considering the impact it has on the ADL. There are numerous scales that allow evaluating how
      spasticity affects post-stroke functionality, even helping to detect which beneficial aspects
      of spasticity should be considered when defining a therapeutic strategy. Among the most used
      scales are the Barthel Index, which assesses the level of patient independence with respect
      to the performance of some ADL. The scientific evidence suggests that patients with
      spasticity have low rates in Barthel.

      The scientific evidence suggests that a careful and continuous evaluation of spasticity,
      would allow to identify establishment times and affected structures; as well as, to recognize
      predictive factors that assist rehabilitation professionals, identifying which patients are
      predisposed to develop spasticity, in order to reduce the risk of its establishment and
      influence its evolution, helping to identify preventive measures and effective interventions,
      that allow to achieve better motor and functional results, promoting its application in
      search of an optimal recovery.

      Given the above, the purpose of the study is to determine the prevalence of patterns and
      their impact on the quality of life of patients after sequelae of a stroke. The generation of
      new scientific evidence acquires vital importance and are key to the management of these
      patients.
    

Intervention name(s): Evaluation Upper Extremity patterns.
Intervention type(s): Diagnostic Test
Intervention description(s): The procedure involves evaluating subjects who meet the eligibility criteria and agree to participate in the study by signing informed consent. The study includes a measurement, applying a registration form, the Barthel scale and the FIM scale.
Other intervention name(s): Evaluation upper extremity patterns after stroke.
Observational model: Ecologic or Community
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        It will consist of 600 subjects with a diagnosis of stroke who attend comprehensive
        rehabilitation centers in regions V, VIII, IX and X in Chile.
      
Keywords: Stroke; Spasticity; Upper Extremity; Quality of Life