Development and use of a new tool for assessing upper and lower limb synergies in people with stroke

Abstract

Background. While abnormal motor synergy is a major characteristic of stroke survivors, a major concern for rehabilitation clinicians, especially physiotherapists, deals with its assessment, evaluation, and meaningful intervention. Objectives. This study was about the development and use of a new tool to measure accuracy in performance of functional motor synergies and activities of daily living in people with stroke. Materials and methods. Thirteen stroke survivors comprising eight with left hemiplegia and five with right hemiplegia participated in this study. Each subject was instructed to perform a total of twenty six activities which involved touch-ing designated point and stepping on designated quadrants. They were all assessed using a developed synergy assessment chart, on which was recorded the synergy assessment score and a developed synergy assessment board, on which was recorded the activity performance profile and abnormal synergy. Results. This study showed that stroke survivors typically exhibit limitation of their motor, functional and daily living activities. Activity performance profile showed that 44.23% of participants exhibited abnormal synergy, 43.98% of activities could be performed in less than 1.5 seconds and 51.53% of activities could be performed in more than 1.5 seconds. Reliability test gave a value of 0.87 using the Cronbach’s alpha. The new tool showed a good inter-item relationship when correlated with the Berg balance scale and Barthel Index (p < 0.001). Conclusion. From the data gathered, the synergy assessment chart and board has a good reliability and inter-item correlation when compared with Berg balance scale and Barthel Index.