Understanding the Relationship Between Sleep and Motor Function After Stroke

Kizilay, Merve (2024) Understanding the Relationship Between Sleep and Motor Function After Stroke. Doctoral thesis, University of East Anglia.

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Abstract

Sleep plays a critical role in neuroplasticity. Therefore, it may influence motor function following stroke. Although evidence suggests a connection between sleep and motor function, this relationship remains inconclusive. Sit-to-walk movement is an essential part of independence in daily life. However, it is rarely investigated. Yet, it offers detailed motor function insights through fluency metrics (coordination, hesitation, and smoothness).

The main research aim of this project is to understand the relationship between sleep and motor function, with motor function measured by fluency metrics derived from STW (Third Study). The second aim is to assess the test-retest reliability of these metrics in non-stroke population (Second Study). A systematic literature review was conducted to synthesise the existing evidence regarding this relationship (First Study).

The systematic review results indicate a modest correlation between sleep and motor function, potentially limited by the heterogeneity of study methodologies.

The Second and Third studies were then carried out in parallel. The second study examined the fluency metrics of the sit-to-walk movement in non-stroke participants and compared them with data from stroke patients. The results demonstrate variable test-retest reliability; the confidence interval fell below the threshold for acceptable reliability (ICC < 0.75) for all variables, indicating low repeatability of measurements. Significant differences were observed in all biomechanical variables between the stroke and non-stroke groups, except for one of the coordination parameters.

The third study investigating the relationship between motor function and sleep found multiple correlations. After controlling for age, gender, and mental health in the linear model, average sleep bouts were the most strongly related sleep variable, followed by sleep quality measured by a Likert scale, time in bed, sleep efficiency, and the Pittsburgh Sleep Quality Index (PSQI).

Biomechanical measurements hold promise in clarifying the link between sleep and motor function by capturing motor function in greater detail. However, the variability observed in fluency metrics during sit-to-walk movements underscores the need for research to verify their reliability.

Item Type:	Thesis (Doctoral)
Faculty \ School:	Faculty of Medicine and Health Sciences > School of Health Sciences
Depositing User:	Chris White
Date Deposited:	30 Oct 2025 11:27
Last Modified:	30 Oct 2025 11:27
URI:	https://ueaeprints.uea.ac.uk/id/eprint/100856
DOI:

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