The Influence of Sensory and Upper limb function on Activities of Daily Living of Patients with Chronic Cerebrovascular Accident

만성 뇌졸중 환자의 감각기능과 상지기능에 따른 일상생활활동 수행능력

  • Song, Won-Il (Division of Occupational Therapy, Samsung Medical Center) ;
  • Cha, Tae-Hyun (Division of Occupational Therapy, Kyungwoon University) ;
  • Woo, Hee-Soon (Division of Occupational Therapy, Woosong University)
  • 송원일 (삼성서울병원 작업치료실) ;
  • 차태현 (경운대학교 작업치료학과) ;
  • 우희순 (우송대학교 작업치료학과)
  • Received : 2011.10.07
  • Accepted : 2011.12.13
  • Published : 2011.12.31


The aim of this study is to evaluate the relationship between sensory function and performances in the activities of daily living in chronic CVA patients. One-hundred and thirty-eight CVA patients, who experienced their CVA more than 6 months ago, were recruited. Their sensory, motor and cognitive functions, as well as performances in activities of daily living were assessed and analysed. The results indicated that Graphesthesia and proprioception of the affected hand of patients with right hemiplegia showed statistically significant correlation with personal hygiene. The motor functions of the unaffected side in patients with left hemiplegia showed statistically meaningful correlation with ADL performances. The correlation between the motor function of upper limb of the unaffected side and the activities of daily living showed statistical significance in both right and left hemiplegia.


  1. World Health Organization. International classification of impairments, disabilities, and handicaps. Geneva, 1980.
  2. Statisstics Korea, "Study on death and the cause of death in 2007", 1992.
  3. Martins, T., Riberto, J. P., & Garrett, C., " Disability and quality of life of stroke survivors: Evaluation nine months after discharge", Revista de Neurologia, Vol. 42, No. 11, pp. 655-659, 2006.
  4. Park, K. J., & Lee, K. W., "Study on Activies of daily living performance individuals with cerebrovascular accident", The Journal of Korean Academy of Occupational Therapy, Vol. 5, No. 1, pp. 27-33, 1997.
  5. Kemp, B. J., & Mitchell, J. M., "Functional Assessment in Geriatric Mental Health. In : Handbook of Mental Health and Aging", 2nd Edition, San Diego: Academic Press, 1992.
  6. Hunt, A., "Some aspects of the health of elderly people in England", Health Trends, Vol. 11, No. 1, pp. 21-23, 1979.
  7. Ferm, L., "Behavioral activities in demented geriatric patients", Reviews in Clinical Gerontology, Vol. 16, No. 4, pp. 413-420, 1974.
  8. Jane, E., Sullivan, & Lois D. Hedman., "Sensory Dysfunction Following Stroke: Incidence, Significance, Examination, and Intervention", The Stroke Rehabilitation, Vol. 15, No. 3, pp. 200-217, 2008.
  9. Schabrun, S. M., & Hillier, S., "Evidence for the retraining of sensation after stroke: a systematic review", Clinical Rehabilitation, Vol, 23, No. 1, pp. 27-39, 2009.
  10. Carey, L. M., "Somatosensory loss after stroke", Critical Reviews in Physsical and Rehabilitation Medicine, Vol. 7, No. 1, pp. 51-91, 1995.
  11. Feys, H. M., De Weerdt, W. J., Selz, B. E., Cox Steck, G. A., Spichiger, R., Vereeck, L. E., Putman, K. D., & Van Hoydonck, G. A., "Effect of a therapeutic intervention for the hemiplegic upper limb in the acute phase after stroke: a single-blind, randomized, controlled multicenter trial", Stroke, Vol. 29, No. 4, pp. 785-792, 1998.
  12. Carey, L. M., Matyas, T. A., & Oke, L. E., " Sensory loss in stroke patients: effective training of tactile and proprioceptive discrimination, Archives of Physical Medicine and Rehabilitation, Vol. 74, No 6, pp. 602-611, 1993.
  13. Tyson, S., Hanley, M., Chillala, J., Selley, A. C., "Sensory loss in hospital-admitted people with stroke: characteristics, associated factors and relationship with function", Neurorehabil and Neural Repair, Vol. 8, No. 8, pp. 1-7, 2007.
  14. Holmgren, H., Leijon, G., Boivie, J., Johansson I, & Ilievska, L., "Central post-stroke pain.somatosensory evoked potentials in relation to location of the lesion and sensory signs", Pain, Vol. 40, No. 1, pp. 43-52, 1990.
  15. Winward, C. E., Haligan, P. W., & Wade, D. T., "Somatosensory recovery: longitudinal study of the first 6 months after unilateral stroke", Disability and Rehabilitation, Vol. 29, No. 4, pp. 293-299, 2007.
  16. Lundgren, J., Flodstrom, K., Sjogren K, Liljequist, B., Fugl-Meyer, A. R., " Site of brain lesion and functional capacity in rehabilitated hemiplegics", Scandinavian Journal of Rehabilitation Medicine, Vol. 14, No. 3, pp. 141-143, 1982.
  17. Chester, C. S., & McLaren, C. E., "Somatosensory evoked response and recovery from stroke", Archives of Physical Medicine and Rehabilitation, Vol. 70, No. 7, pp. 520-525, 1989.
  18. Kusoffsky, A., Wadell, I., & Nuksson, B. Y., " The relationship between sensory impairment and motor recovery in patients with hemiplegia", Scandinavian Journal of Rehabilitation Medicine, Vol. 14, No. 1, pp. 27-32, 1982.
  19. La Joie, W. J., Reddy, N. M., & Melvin, J. L., " Somatosensory evoked potentials: their predictive value in right hemiplegia. Archives of Physical Medicine and Rehabilitation, Vol. 63, No. 5, pp. 223-226, 1989.
  20. van Buskirk, C., & Webster, D., "Prognostic value of sensory deficit in rehabilitation of hemiplegics", Neurology, Vol. 5, No. 6, pp. 407-411, 1955.
  21. Tyson, S. F., Hanley, M., Chillala, J., Selley, A, & Tallis, R. C., "Balance disability after stroke", Physical Therapy, Vol. 86, No. 1, pp. 30-38, 2006.
  22. Sorock, G. S., & Labiner, D. M., "Peripheral neuromuscular dysfunction and falls in an elderly cohort", American Journal of Epidemiology, Vol. 136, No. 5, pp. 584-591, 1992.
  23. Yates, J. S., Lai, S. M., Duncan, P. W., & Studenski, S., "Falls in community-dwelling stroke survivors: an accumulated impairments model", Journal of Rehabilitation Research and Development, Vol. 39, No. 3, pp. 385-394, 2002.
  24. Cheng, P. T., & Hong, C. Z., "Prediction of reflex sympathetic dystrophy in hemiplegic patients by electromyographic study", Stroke, Vol. 26, No. 12, pp. 2277-2280, 1995.
  25. Daviet, J. C., Preux, P. M., Salle, J. Y., Lebreton, F., Munoz, M., dudognon, P., Pelissier, J., & Perrigot, M., "Clinical factors in the prognosis of complex regional pain syndrome type I after stroke: a prospective study", Archives of Physical Medicine and Rehabilitation, Vol. 81, No. 1, pp. 34-39, 2002.
  26. Pertoldi, S., Di Benedetto, P., "Shoulder-hand syndrome after stroke. A complex regional pain syndrome", European Journal of Physical and Rehabilitation Medicine, Vol. 41, No. 4, pp. 283-292, 2005.
  27. Hartman-Maeir, A., Soroker, N., & Katz, N., "Anosognosia for hemiplegia in stroke rehabilitation", Neurorehabilitation and Neural Repair, Vol. 15, No. 3, pp. 213-222, 2001.
  28. Levine, D. N., Calvanio, R., & Rinn, W. E., "The pathogenesis of anosognosia for hemiplegia", Neurology, Vol. 41, No. 11, 1770-1778, 1991.
  29. Boomkamp-Koppen, H. G., Visser-Meily, J. M., Post, M. W., & Prevo, A. J. "Poststroke hand swelling and oedema: prevalence and relationship with impairment and disability", Clinical Rehabilitation, Vol. 19, No. 5, pp. 552-555, 2005.
  30. Chang, J. J., Tsau, J. C., & Lin, Y. T., "Predictors of shoulder subluxation in stroke patients", The Kaohsiung Journal of Medical Sciences, Vol. 11, No. 5. 250-256, 1995.
  31. McClatchie, G., "Survey of the rehabilitation outcomes of strokes", The Medical Journal of Australia, Vol. 1, No. 13, pp. 649-651, 1980.
  32. Shin, J. B., Joe, K. J., & Shin, J. S., "The ADL evaluation of the disabled", The Journal of Korean Academy of Rehabiltation Medicine, Vol. 11, No. 1, pp. 10-21, 1987.
  33. Pedretti, L. W., "Occupational therapy: Practice skills for Physical dysfunctioin", St. Louis: Mosby, 2001.
  34. Korea Institute for special education, "Activities of daily living introduction for individuals with cerebral palsy", 1997.
  35. Butefisch, C., Hummelsheim, H., Denzler, P., & Mauritz, K. H., "Repetitive training of isolated movements improves the outcome of motor rehabilitation of the centrally paretic hand", Journal of the Neurological Sciences, Vol. 130, No. 1, pp. 59-68, 1995.
  36. Dennis, A. Nowak., "The impact of stroke on the performance of grasping: Usefulness of kinetic and kinematic motion analysis", Neuroscience and Biobehavioral Reviews, Vol. 32, No. 8, pp. 1439-1450, 2008.
  37. Gresham, G. E., "Rehabilitation of the geriatric patient. Stroke rehabilitation, the rehabilitation team, and the usefulness of functional assessment", Primary Care, Vo. 9, No. 1, pp. 239-247, 1982.
  38. Lee, T. Y., Oh, J. K., Kim, H. Y., Lee, K. S., & Kim, M. H., "The effects of the involved upper extremity's function on the dexterity of uninvolved hand in stoke patients", The Journal of Korean Academy of Occupational Therapy, Vol. 7, No. 1, pp. 56-67, 1999.
  39. Jung, H. Y., Gwon, H. G., & Oh, J. H., "The study on the initial evaluation in the beginning of rehabilitation and the functional outcome in stroke", The Journal of Korean Academy of Rehabiltation Medicine, Vol. 15, No. 4, pp. 398-404, 1991.
  40. Han, T. R., Kim, J. H., Lee, S. J., & Kim, S. B., "The significance of the hand function test in the hemiplegic patients", The Journal of Korean Academy of Rehabiltation Medicine, Vol. 16, No. 4, pp. 423-430, 1992.
  41. Pfeffer, R. I., Kurosaki, T. T., Harrah, C. H., Chance, J. M., & Filos, S., "Measurement of functional activities in older adults in the community", The Journal of Gerontology, Vol. 37, No. 3, pp. 323-329, 1982.

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