Time-related changes in motor performance of the upper extremity ipsilateral to the side of the lesion in stroke survivors.

OBJECTIVE: The objective of the present study was to examine time-related changes in motor performance of daily tasks of the upper extremity ipsilateral to the side of lesion in poststroke hemiparetic patients. METHODS: Nine patients after an acute uniliteral cerebrovascular accident and 10 age-matched healthy controls were studied. Functional motor abilities of the upper extremity ipsilateral to side of lesion were examined over a 4-month time course, using validated measurement tools (Jebsen test of hand function, nine-hole peg test, and three functional activities of daily living). RESULTS: The results indicated a significant impairment in the motor function of the hand ipsilateral to the side of brain lesion in comparison with the matched extremity in control subjects. They also pointed to time-related improvement in performance speed, implying that the deterioration in the functional performance of the upper extremity on the uninvolved body side of poststroke hemiparetic patients is not static and may improve with time. The findings further suggested that the left hand of patients with an intact right cerebral hemisphere improves more than does the right hand of their peers whose left cerebral hemisphere is intact. CONCLUSIONS: Due to the small sample size and methodologic considerations, further and more extensive work is required to determine difference in improvement in motor abilities of the ipsilateral left versus the ipsilateral right upper extremities in stroke survivors.

Self-evaluation of psychotherapeutic competence.

The authors investigated the process of change of self-evaluation of therapeutic competence in psychotherapists enrolled in a postgraduate training programme of psychotherapy. An analysis of the relationships between self-evaluated therapeutic skills and level or stage of formal training was performed. The results of this study suggest that a higher level of self-evaluated therapeutic skill among applicants was followed by a decline in self-evaluation as the training progressed, and a gradual increase in self-evaluation towards the end of formal training. The findings reveal a curvilinear pattern of change which suggests specific internal cognitive/emotional processes leading to the formation of a professional self-image as a psychotherapist.