The impact of social-cognitive factors on paretic hand use post-stroke in the natural environment

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Yi-An Chen

At a Glance

  • Location: Los Angeles, USA
  • Date: 14.10.2014
  • Institution: University of Southern California
    Division of Biokinesiology and Physical Therapy
  • Web Page:


  • Context: -
  • Number of participants: 50 (estimated; 10 healthy adults, 40 individuals with stroke)
  • Number of days per participants: 7
  • Number of prompst per Day: 8
  • Number of Items: 25-30



Limited use of the paretic hand after stroke can severely constraint individuals’ activity/participation and lead to further functional degradation. A great deal of clinical research has emphasized facilitating physical motor improvement of the paretic limb to promote paretic hand use. However, the avoidance of using paretic hand can still be observed in patients with stroke.

We posits that exclusively focusing on the physical motor improvement may not be enough for individuals to persistently use their paretic hand in the natural environment. Recent studies suggest that social-cognitive factors, which characterize individuals’ perception/feelings and psychological needs, play an essential role in individuals’ functioning. Nevertheless, the relationship of the social-cognitive factors, including self-efficacy, autonomy, social-relatedness and affect, to hand use is not well understood.

Purpose & Hypothesis:

The aim of this pilot study is to investigate the impact of social-cognitive factors on paretic hand use post-stroke in the natural environment. We hypothesize that social-cognitive factors will have a strong impact on stroke survivors’ decision-making in paretic hand use in daily activities.
Our preliminary work has demonstrated a significantly positive correlation between one social-cognitive factor (self-efficacy) and paretic hand use during a laboratory reaching task. Identifying the influence of the social-cognitive factors on the paretic hand use in daily activities will improve paretic hand use in community life post-stroke to sustain and enhance the motor improvements achieved in clinics.

The survey questions entered in the smartphone are related to the daily activities the stroke survivors are doing with their paretic limb and their social-cognitive factors of paretic limb use. Each survey will take around 3-4 minutes to complete.

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