Understanding and alleviating the mismatch between observed and perceived upper limb function after stroke

In people post stroke, we recently reported a mismatch between observed and perceived upper limb function, i.e. a group of patients at six months after stroke showed good upper limb function but low perceived ability. Building on this knowledge, this project will systematically address the subsequent research questions arising from our previous analysis. Through a longitudinal observation of evolution of mismatch between six and 12 months post stroke, the project will give insight into whether this group of patients with a mismatch increases over time. By investigating the relation between mismatch at six and 12 months and variables on admission to inpatient rehabilitation, this proposal will identify key predictors early after stroke for risk of mismatch in the chronic stage. A crosssectional study to understand the relation between mismatch and actual daily use of the upper limb through sensor technology will provide pivotal information on daily arm use in this group of chronic stroke patients. Finally results from an integrative randomized controlled cross-over trial, with clinical, patient-reported and sensor technology outcomes, examining a two-week boost therapy program for patients with this mismatch between observed and perceived upper limb function, will impact on therapy care of these patients in the chronic phase after stroke.