Longitudinal associations between paretic upper limb use,motor function,and internal health locus of control in hospitalised patients with subacute stroke
Restricted accessResearch articleFirst published online 2026
Longitudinal associations between paretic upper limb use,motor function,and internal health locus of control in hospitalised patients with subacute stroke
This study longitudinally examined the associations between paretic upper limb use, upper limb motor function, and Internal Health Locus of Control (IHLC) in hospitalised patients with subacute stroke. Forty patients were assessed using the Motor Activity Log–Amount of Use, the Fugl–Meyer Assessment-Upper Extremity, and IHLC. Hierarchical multiple regression analyses showed that paretic upper limb use was associated with motor function at both 1 and 2 months, whereas no association with IHLC was observed. Secondary (exploratory) analyses suggested that depressive symptoms, self-efficacy, and activities of daily living independence may differ according to the degree of improvement in paretic upper limb use.
AjzenI (1991) The theory of planned behavior. Organizational Behavior and Human Decision Processes50(2): 179–211.
2.
BanduraA (1977) Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review84(2): 191–215.
3.
BonettiDJohnstonM (2008) Perceived control predicting the recovery of individual-specific walking behaviours following stroke. British Journal of Health Psychology13(3): 463–478.
4.
BrunnstromS (1966) Motor testing procedures in hemiplegia: Based on sequential recovery stages. Physical Therapy46(4): 357–375.
5.
ChenCMTsaiCCChungCY, et al. (2015) Potential predictors for health-related quality of life in stroke patients undergoing inpatient rehabilitation. Health and Quality of Life Outcomes13: 118.
6.
ChenSWolfSLZhangQ, et al. (2012) Minimal detectable change of the actual amount of use test and the motor activity log. Neurorehabilitation and Neural Repair26(5): 507–514.
7.
ChenYWLiYCHuangCY, et al. (2023) Predicting arm nonuse in individuals with good arm motor function after stroke rehabilitation. International Journal of Environmental Research and Public Health20(5): 4123.
8.
ChinoN (1991) Development of the Japanese version of the Functional Independence Measure (FIM). The Japanese Journal of Rehabilitation Medicine28(6): 425–428.
9.
Fugl-MeyerARJääsköLLeymanI, et al. (1975) The post-stroke hemiplegic patient. I. A method for evaluation of physical performance. Scandinavian Journal of Rehabilitation Medicine7(1): 13–31.
10.
FukudaKKobayashiS (1973) A study on a self-rating depression scale. Psychiatria et Neurologia Japonica75: 322–330.
11.
GBD 2019 Stroke Collaborators (2021) Global, regional, and national burden of stroke and its risk factors, 1990–2019: A systematic analysis for the Global Burden of Disease Study 2019. The Lancet Neurology20(10): 795–820.
12.
GeddesJMFearJTennantA, et al. (1996) Prevalence of self-reported stroke in a population in northern England. Journal of Epidemiology and Community Health50(2): 140–143.
13.
GladstoneDJDanellsCJBlackSE (2002) The Fugl–Meyer Assessment of motor recovery after stroke: A critical review of its measurement properties. Neurorehabilitation and Neural Repair16(3): 232–240.
14.
GrangerCVHamiltonBBKeithRA, et al. (1986) Advances in functional assessment for medical rehabilitation. Topics in Geriatric Rehabilitation1(3): 59–74.
15.
HiragaYHayashiT (2022) Mediating effect of upper limb use on the relationship between upper limb performance and activities of daily living: A longitudinal mediation analysis. Cureus14(10): e30849.
16.
HirayamaKMatsudaMTeruyaM, et al. (2023) Trends in amount of use to upper limb function in patients with subacute stroke. BMC Neurology23: 429.
17.
HorikeH (1991) A Japanese version of the Health Locus of Control scales. The Japanese Journal of Health Psychology4(1): 1–7.
18.
KatoSShimogakiHOnoderaA, et al. (1991) Development of the revised Hasegawa’s Dementia Scale (HDS-R). Japanese Journal of Geriatric Psychiatry2(11): 1339–1347.
19.
KwakkelGVeerbeekJMvan WegenEEH, et al. (2015) Constraint-induced movement therapy after stroke. The Lancet Neurology14(2): 224–234.
20.
NáfrádiLNakamotoKSchulzPJ (2017) Is patient empowerment the key to promote adherence? A systematic review of the relationship between self-efficacy, health locus of control and medication adherence. Plos One12(10): e0186458.
21.
Nichols-LarsenDSClarkPCZeringueA, et al. (2005) Factors influencing stroke survivors’ quality of life during subacute recovery. Stroke36(7): 1480–1484.
22.
OkawaYHaseKNagasawaY, et al. (1994) Validation study of the Japanese version of the Functional Independence Measure (FIM). The Japanese Journal of Rehabilitation Medicine31(10): 735–742.
23.
RandDEngJJTangP F, et al. (2011) Using accelerometers to quantify arm use after stroke. Stroke42(11): 3211–3217.
24.
RapolienėJEndzelytėEJasevičienėI, et al. (2018) Stroke patients’ motivation influence on the effectiveness of occupational therapy. Rehabilitation Research and Practice2018: 9367942.
25.
SakanoYTohjohM (1986) The general self-efficacy scale (GSES): Scale development and validation. Japanese Journal of Behavior Therapy12(1): 73–82.
26.
SugishitaMHenmiITakeuchiT (2016) Re-examination of the validity and reliability of the Mini-Mental State Examination–Japanese version (MMSE-J). Japanese Journal of Cognitive Neuroscience18(3–4): 168–183.
27.
TakahashiKDomenKSanoK, et al. (2009) Reliability and validity of the Motor Activity Log in Japan. Japanese Occupational Therapy Research28: 628–636.
28.
TaubEUswatteGElbertT (2002) New treatments in neurorehabilitation founded on basic research. Nature Reviews Neuroscience3(3): 228–236.
29.
TaubEUswatteGMarkVW, et al. (2006) The learned nonuse phenomenon: Implications for rehabilitation. Eura Medicophys42(3): 241–256.
30.
UswatteGTaubEMorrisD, et al. (2005) Reliability and validity of the upper-extremity Motor Activity Log-14 for measuring real-world arm use. Stroke36(11): 2493–2496.
31.
Van der LeeJHBeckermanHLankhorstGJ, et al. (1999)Constraint-induced movement therapy. Archives of Physical Medicine and Rehabilitation80(12): 1606–1607.
32.
Van MierloMLSchröderCVan HeugtenCM, et al. (2014) The influence of psychological factors on health- related quality of life after stroke: A systematic review. International Journal of Stroke9(3): 341–348.
33.
WahlAKOpsethGNolteS, et al. (2018) Is regular use of physiotherapy treatment associated with health locus of control and self-management competency?Musculoskeletal Science and Practice36: 43–47.
34.
WallstonBSWallstonKAKaplanGD, et al. (1976) Development and validation of the health locus of control (HLC) scale. Journal of Consulting and Clinical Psychology44(4): 580–585.
35.
WolkS (1976) Situational constraint as a moderator of the relationship between locus of control and adjustment. Journal of Consulting and Clinical Psychology44(4): 577–585.
36.
ZungWWK (1965) A self-rating depression scale. Archives of General Psychiatry12(1): 63–70.
