The post-stroke upper limb improvement effort survey (IMPETUS): a survey of individuals with chronic stroke

Background: There is a considerable literature on arm/hand dysfunction post stroke, but little information on the participants’ opinions about perceived and desired arm/hand strength, recovery, and function. Objective: The objective of this study was to examine the perceptions of individuals with stroke about arm/hand function and training devices. Methods: A 69-item survey was developed addressing: activity before and after stroke, involved arm/hand function, willingness to use a training device, and important device characteristics. The survey included items from the Hand Function and Strength Subscales of the Stroke Impact Scale (SIS). Face validity was established by physical therapists and individuals with stroke. The survey was administered via phone and online. Results: 852 registry participants were recruited. Ninety-seven responded; 83 completed the survey. Subjects were 51 males, 31 females; mean age: 65 (25–95); meantime since stroke: 13 years (1–34; SD 6.678). There was a statistically significant difference between perceived and desired arm/hand strength, recovery, and function p<0.0001. Impairment factors, such as weakness and spasticity were greater barriers to recovery than socio-economic ones. Most participants (94%) were willing to use a device; functional gains during/following use were the most important characteristics. Limitations: Participants had greater arm impairment and were more chronic than other studies. Conclusions: Participants desired more arm/hand strength, function, and recovery that they perceived they had achieved. Impairment–level factors posed more barriers to arm recovery than socioeconomic ones. Most participants were interested in using arm/hand training devices; the most important device characteristic is functional gain.