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.

Author(s) Disclosures: None.