An Investigation of the Neuromuscular Correlates of Upper Limb Movement Recovery After Stroke

Yüksel, Canan (2025) An Investigation of the Neuromuscular Correlates of Upper Limb Movement Recovery After Stroke. Doctoral thesis, University of East Anglia.

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Abstract

Stroke survivors often face neuromuscular impairments and functional limitations in their upper limbs (ULs), significantly affecting their daily lives and independence (1–3). Understanding the relationships between neuromuscular impairments and functional abilities in the UL post-stroke is crucial for developing effective rehabilitation strategies (4–6). This doctoral research contributes to this understanding through three original studies:

A systematic review assessed exercise-based therapies’ impact on neuromuscular impairments and functional abilities in stroke survivors. It determined that exercise-based therapies simultaneously enhance both aspects, without significant differences between the improvements. An almost perfect correlation was found between these improvements, suggesting that exercise-based therapies included in the review enhance functional ability without adversely affecting neuromuscular impairment.

A correlational agreement study, using advanced technological methods, identified reference values, test-retest reliability and smallest detectable changes for neuromuscular impairment and functional ability variables in adults without mobility-impairing conditions. The 'Time to Task Completion (TTC)', 'Reach Path Ratio (RPR)', and 'Movement Smoothness (MS)' variables showed high absolute reliability despite overall test-retest reliability being insufficient across the variables assessed.

A longitudinal observational cohort study involving stroke survivors assessed twice post-stroke focused on the relationships and stability of neuromuscular impairments and functional abilities. It revealed that the Fugl-Meyer Assessment (FMA), MS, and RPR consistently demonstrated significant and stable relationships with functional ability.

These findings suggest that targeting neuromuscular impairments in post-stroke rehabilitation can be an effective and efficient approach to improving functional ability. MS, RPR and neuromuscular impairments, as captured by FMA, consistently displaying significant and stable relationships with functional ability, can be effective therapeutic targets for enhancing stroke survivors' functionality. The use of sensitive assessment instruments in stroke research and clinical practice can help to refine the understanding of the relationships between neuromuscular impairments and functional abilities, thereby advancing rehabilitation strategies and supporting the functional recovery of stroke survivors.

Item Type:	Thesis (Doctoral)
Faculty \ School:	Faculty of Medicine and Health Sciences
Depositing User:	Kitty Laine
Date Deposited:	17 Mar 2025 14:15
Last Modified:	17 Mar 2025 14:16
URI:	https://ueaeprints.uea.ac.uk/id/eprint/98762
DOI:

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