The Impact of Perceptual Impairment on Social Participation in Stroke Patients

The BBT is a test of manual dexterity and was originally developed to evaluate the gross manual dexterity of adults with cerebral palsy. A box with a partition directly in the center creating two equal sides is used in the test. Small wooden blocks are placed in one side of the box. The participant is required to use the unaffected had to grasp one block at a time and transport it over the partition and release it into the opposite side. 60 seconds is given to complete the test, and the number of blocks transported to the other side is counted. Then the participant is asked to repeat the same task with the affected hand. The BBT is administered 3 times during the study period.

The MAS is a 5-point ordinal scale to evaluate muscle tone of upper-extremity. Higher scores indicate a more severe hypertonia. This measure is administered 3 times during the study period.

The MRC scale assesses muscle power with scores ranging from 0 (no contraction) to 5 (normal power). The muscle strength of shoulder flexors/abductors, elbow flexors/extensors, wrist flexors/extensors, and finger extensors are graded. The MRC is administered 3 times during the study period.

The WMFT is used to assess the upper extremity function. The WMFT consists of 17 tasks, including 15 function tasks and 2 strength tasks. We only used the sum of the 15 functional tasks. The 15 functional tasks are timed (WMFT-TIME) and rated by using a 6-point functional ability scale (WMFT-FAS) where 0 indicates "does not attempt with the involved arm" and 5 represents "arm does participate; movement appears to be normal." The maximum score is 75. Higher scores are indicative of higher functioning levels. The WMFT is administered 3 times during the study period.

The ARAT is used to evaluate upper extremity function. It consists of 19 items, and tasks are scored on a 4-point scale. A maximum of a total score 57 indicates normal performance. This measure is administered 3 times during the study period.

The NEADL scale is a measure of Instrumental ADL ability, comprising sub-scales for mobility, household ability and leisure activity. The NEADL consists of 22 activity items, scoring on the basis of the required level of assistance. The range of total score is 0-66, and higher score representing better function. This measure is administered 3 times during the study period.

The AAP is used to assess life-style activities of the elderly. The AAP asks elderly people to provide responses which reflect their performance of 21 activities in a typical three-month period. Each activity is rated using four possible responses, scored 0, 1, 2 or 3 to indicate increasing frequency of activity. It consists of activities in domestic chores, household maintenance, service to others, and social activities. This measure is administered 3 times during the study period.

The ABILHAND questionnaire is a self report assessment that assesses the UE function that consists of 23 bilateral activities in the daily life. Patients were asked to estimate their difficulty in performing each activity.The ABILHAND is a 3-point ordinal scale, which the higher scores mean the more difficulty patients feel. This measure is administered 3 times during the study period.

The MAL is a semi-structured interview of patients to assess the amount of use (AOU) and quality of movement (QOM) of the affected upper extremity in 30 important daily activities using a 6-point ordinal scale. Higher scores indicate superior amount and quality of use in affected upper extremity. Each task is scored on a 6-point scale, ranging from 0 to 5. This measure is administered 3 times during the study period.

The SIS 3.0 is a stroke-specific instrument of health-related quality of life and contains 59 items measuring 8 domains. Items are rated on a 5-point Likert scale with lower scores indicate greater difficulty in task completion during the past week. Aggregate scores, ranges from 0 to 100, are generated for each domain. It is administered 3 times during the study period.

The NLQ was developed to measure such decline in patients with a stroke and to monitor the effects of interventions on leisure. The NLQ lists 37 leisure items and has five possible response categories (very regularly, regularly, occasionally, infrequently, never). Higher scores denote a greater number of activities performed and/or greater frequency of activity. This measure is administered 3 times during the study period.

The LSS evaluates the extent to which individuals feel that their needs are met through their leisure activities. The LSS included 24 Likert scale items (1=strongly disagree, 5=strongly agree). Categories included psychological, educational, social, relaxational, physiological, and aesthetic effects. A total score for each area and overall LSS score are calculated. This measure is administered 3 times during the study period.

The RNLI is an assessment of the quality of life (QOL) of people with disabilities. It includes 11 items. Concepts measured by the RNLI include mobility, self-care, daily activity, recreational activity, and family roles. The 100-point scale used a visual analog scale (VAS) anchored by opposing phrases. Higher scores indicate better QOL. This measure is administered 3 times during the study period.