Assessment of Functional Efficiency of the Upper Limb After Stroke

Barthel scale - to assess activities of daily living. A maximum of 100 points can be obtained. Based on the points awarded, we assess the patient's condition as: I. 86-100 points - patient's condition "mild"; II. 21- 85 points - patient's condition "moderately severe"; III. 0 - 20 points - patient's condition "very severe".

VAS scale - for subjective assessment of pain intensity, most often in the form of a line with special markings, from 0 - which means complete lack of pain, to 10 - which means unbearable pain (the greatest pain the patient can imagine). On the scale VAS: 0 means no pain, 1-3 mild pain, 4-7 moderate pain, above 7 - severe pain, 10 - unbearable pain.

WHOQOL-BREF questionnaire for assessing quality of life - which allows for obtaining an assessment of quality of life for the last 14 days in four assessed domains: somatic, psychological, social and environmental. Answers to questions included in the WHOQOL-Bref scale are classified on a five-point scale, with a higher score indicating a better perception of quality of life in a given area. The obtained number of points is converted to a 100-point scale, with a higher score being considered a sign of higher quality of life.

Stroke Quality of Life Scale - (SSQOL) is one of the specific tools used to assess quality of life determined by health status after stroke. SSQOL allows for obtaining a profile in the scope of global quality of life from 2 domains - physical and psychosocial and 12 subscales. Each of the SSQOL subscales contains 3 to 6 items - 49 in total. The SSQOL has two sets of answers, which concern the patient's functioning in the past week. They were developed on the basis of a 5-point Likert scale (1.0 - 5.0), where a higher score indicates better functioning in a given area.

Box and Blocks test to assess the manual dexterity of the hand. The test consists of a wooden box (53.7 cm x 25.4 cm x 8.5 cm) divided into two parts by a partition and 150 blocks (2.5 cm). The test consists of the patient transferring as many blocks as possible from one compartment of the box to another of equal size within 60 seconds. The box should be placed in the patient's midline so that during transfer the blocks are transferred through the partition. Before performing the actual test, the patient can perform the test for 15 seconds and start the test with the unoccupied hand. A higher number of transferred blocks indicates better manual dexterity of the patient.

Franchay scale for assessing the grip function of the hand. The scale consists of 7 tasks - pass/fail, and the patient scores 1 point for each successfully completed task or 0 for failure to perform. Using the paretic hand, the patient attempts to unscrew a jar, lift and put back a 2-inch diameter cylinder (later ½ inch diameter). The next task is to use the paretic hand to drink water from a glass, comb one's hair, open and close a clothing case. The maximum possible sum of points for performing the above activities is 7. The more points the patient scores, the better the manual dexterity of the hand. This scale is a measure of proximal control of upper limb movements and manual dexterity of the hand. Studies show that the Franchay scale is characterized by excellent reliability and is a reliable tool in assessing the grip function of the hand of people after stroke

Fugl-Meyer Motor Assessment Scale for Upper Extremity for assessing the motor skills of the hand. The hand function test assesses: precision movements and grip. The score is 0-2 for each activity. Items are scored on a 3-point ordinal scale:

0 = cannot perform

1. = performs partially
2. = performs fully. The more points the patient scores, the better the motor skills of the hand.

measurements to be performed with a dynamometer The dynamometer registers strength lower than up to 90 kg,

Measurements to be performed with a pinch meter. The pinch meter registers strength lower than up to 22 kg.

Functional electrostimulation and EMG using the Stella Bio device. This is a muscle activity imaging test. The reading of the bioelectric activity of the muscles is transmitted in the form of numbers and graphs to the screen of the device, thanks to which feedback is obtained on the muscle activity.

Body height will be measured to the nearest 0.1 cm using a portable PORTSTAND 210 stadiometer.

Body weight will be measured to the nearest 0.1 kg using a Tanita 780 body composition analyzer

The body mass index (BMI) will be calculated, and then the BMI value will be related to the obesity classification according to the WHO: ≤ 18.49 underweight, 18.5 - 24.99 normal body weight, 25 - 29.99 overweight, ≥ 30 obesity.

The Modified Ashworth Scale (MAS) is a revised version of the original Ashworth Scale that measures spasticity in patients with lesions to the central nervous system. MAS is an assessment that is used to measure the increase in muscle tone. MAS assigns a grade of spasticity from a 0-4 ordinal scale. The grade is assigned by moving a joint/muscle through a high velocity quick stretch.

0 - No increase in muscle tone

1 - Slight increase in muscle tone, manifested by a catch and release or by minimal resistance at the end of the range of motion when the affected part(s) is moved in flexion or extension

1+ - Slight increase in muscle tone, manifested by a catch, followed by minimal resistance throughout the remainder (less than half) of the ROM (range of movement) 2 - More marked increase in muscle tone through most of the ROM, but affect part(s) easily moved 3 - Considerable increase in muscle tone passive, movement difficult 4 - Affected part(s) rigid in flexion or extension

Motor performance (function) of extremities is to be assessed using Brunnström scale. This is a six-point scale designed to evaluate performance (function) of paretic extremities.The higher the score, the better. 1-No moves 6-Precise movements, ball throw, button fastening and unfastening

Assessment of disability using the modified Rankin scale (MRS) Score Description 0 - No symptoms at all 1- No significant disability despite symptoms; able to carry out all usual duties and activities; 2 - Slight disability; unable to carry out all previous activities, but able to look after own affairs without assistance; 3 - Moderate disability; requiring some help, but able to walk without assistance; 4 - Moderately severe disability; unable to walk without assistance and unable to attend to own bodily needs without assistance; 5 - Severe disability; bedridden, incontinent and requiring constant nursing care and attention; 6 - Dead TOTAL (0-6)

Measurement using the R500 goniometer to assess the range of motion of the joints of the upper limbs. The device works with an accuracy of one degree and is automatically transferred to special software via Bluetooth wireless connection.