A stroke often results in functional impairments of the affected upper limb and in distorted upper limb use of the affected arm in daily life (ULUaff). It is currently unclear how ULUaff recovers after stroke and how it relates to upper limb function (ULF). Therefore, the aims of this study were to explore the recovery of ULUaff post-stroke and its relationship with the recovery of ULF during rehabilitation.

In fifteen people after stroke receiving ‘usual care’ in a rehabilitation center, ULUaff and ULF was assessed at 3, 12, and 26 weeks post-stroke. ULUaff was estimated for one week using an activity monitor consisting of three accelerometers: one on the unaffected leg and one on each wrist and was defined as the ratio of the amount of movement of the affected arm divided by the unaffected arm, with 1 expressing equal levels of use. ULF was measured with the Fugl–Meyer Assessment (FMA).

Data of 10 participants could be used for analysis. At 3 weeks, ULUaff was on average 0.26 with a large interindividual variability (ranging from 0.14 to 0.62). The average ULUaff increased to 0.37 at 12 weeks and 0.43 at 26 weeks. The recovery patterns also showed a large inter-individual variability (Fig. 1). Changes in ULUaff had no significant correlation with changes in ULF (r = 0.48, P = 0.18**, Fig. 2).

At group level the amount of use of the affected arm is strongly affected in the 6-month period after a stroke, but increases over time. However, considerable inter-individual differences were found, in the amount at three time moments post-stroke as well as in the recovery patterns. Recovery of use of the affected arm was not related to recovery of upper limb function.