33 NA-CONTROL STUDY PROTOCOL 2 C. Participation: participation is assessed using the following measures: i. Utrecht scale for evaluation of rehabilitation-participation (USER-P) The USER-P is used to evaluate the effect of outpatient rehabilitation on participation. 54 ii. Canadian Occupational Performance Measure (COPM) The COPM is used to evaluate occupational performance and satisfaction with performance of the most important daily occupations identified as problematic by the patient. It thus assesses occupational participation. 55 The COPM is administered during the first and last sessions of the specific rehabilitation program. 1 These assessments will serve as a pre-intervention and post-intervention comparison within patients with NA who underwent the experimental intervention. D. Body functions: within the body functions domain, we will assess the reachable workspace and several muscles/muscle groups i. 3D-reachable workspace Reachable workspace is an objective measure of upper extremity impairment. 56 It is quantified by the relative 3D surface area representing the portion of the unit hemisphere that is covered by the hand movements made during a standardized movement protocol. 56 The movement protocol covers cardinal movements of the shoulder and is performed in front of the Microsoft Kinect sensor-based reachable workspace analysis system. 56 ii. The following strength measurements will be performed to determine maximal force exerted with several muscles/muscle groups on both sides (left and right upper extremity) i. The serratus anterior muscle measured using the MicroFET2®, digital manual muscle dynamometer, with the arm lifted to shoulder level, in the scapular plane while ii. Reaching with the arm extended iii. Reaching with a flexed arm (elbow at 90°). iv. Rotation of the shoulder measured using the MicroFET2®, digital manual muscle dynamometer, with the arm at 0° anteflexion, elbow flexed at 90° and thumb pointing upwards 1. Endorotation 2. Exorotation v. Hand gripmeasured using the Jamar® Hydraulic Hand dynamometer, with the arm at 0° anteflexion, elbow flexed at 90° and straight wrist. vi. Pinch grip measured using the Baseline® LiTE Hydraulic Pinch Gauge with the arm at 0° anteflexion and elbow flexed at 90°. The pinch gauge is held between the index finger (top) and thumb. vii. Key grip measured with Baseline® LiTE Hydraulic Pinch Gauge, with the arm at 0° anteflexion, elbow flexed at 90°. The pinch gauge is held between the thumb (top) and index finger (bottom). E. Quality of life: quality of life will be assessed using the following questionnaire: i. Short-Form 36 (SF-36) The SF-36 assesses experienced health and health-related quality of life. 57
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