Assessment of upper extremity impairment, function, and activity after stroke: foundations for clinical decision making

J Hand Ther. Apr-Jun 2013;26(2):104-14;quiz 115. doi: 10.1016/j.jht.2012.06.005. Epub 2012 Sep 10.


The purpose of this review is to provide a comprehensive approach for assessing the upper extremity (UE) after stroke. First, common UE impairments and how to assess them are briefly discussed. Although multiple UE impairments are typically present after stroke, the severity of one's impairment, paresis, is the primary determinant of UE functional loss. Second, UE function is operationally defined and a number of clinical measures are discussed. It is important to consider how impairment and loss of function affect UE activity outside of the clinical environment. Thus, this review also identifies accelerometry as an objective method for assessing UE activity in daily life. Finally, the role that each of these levels of assessment should play in clinical decision making is discussed to optimize the provision of stroke rehabilitation services.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Activities of Daily Living*
  • Decision Making
  • Female
  • Hand Strength / physiology*
  • Humans
  • Male
  • Muscle Weakness / physiopathology
  • Paresis / etiology
  • Paresis / rehabilitation*
  • Physical Therapy Modalities
  • Psychomotor Performance / physiology
  • Recovery of Function
  • Risk Factors
  • Severity of Illness Index
  • Stroke / complications
  • Stroke Rehabilitation*
  • Treatment Outcome
  • Upper Extremity / physiopathology*