Predicting recovery of dextrous hand function in acute stroke

Purpose. To determine the clinical characteristics during acute stroke that predicted dextrous function in the paretic hand at 6 months post-stroke. Method. Fifty-seven patients within 5 days post-stroke were recruited in stroke wards. Recovery of dextrous hand function, indicated by a score of ≥35...

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Bibliographic Details
Published in:Disability and rehabilitation 2009-01, Vol.31 (5), p.394-401
Main Authors: Au-Yeung, Stephanie S. Y., Hui-Chan, Christina W. Y.
Format: Article
Language:English
Subjects:
Action research
Aged
Brain
dextrous hand function
Disability Evaluation
Female
Hand - physiopathology
Hand Strength
Humans
Longitudinal Studies
Male
Middle Aged
Motor Skills
muscle strength
Muscles
Odds Ratio
Paresis - rehabilitation
Predictor
Prospective Studies
Recovery
Recovery of Function
ROC Curve
Severity
stroke
Stroke - physiopathology
Stroke Rehabilitation
Strokes
two-point discrimination
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Summary:Purpose. To determine the clinical characteristics during acute stroke that predicted dextrous function in the paretic hand at 6 months post-stroke. Method. Fifty-seven patients within 5 days post-stroke were recruited in stroke wards. Recovery of dextrous hand function, indicated by a score of ≥35 of Action Research Arm Test, was assessed weekly in the first 4 weeks then monthly till 6 months post-stroke. The seven predictor candidates evaluated included side and site of brain infarct, stroke severity, cognition, spatial neglect, two-point discrimination (2-PD), muscle tone and muscle strength of the paretic upper extremity (UE). Results. Site of infarct, stroke severity, 2-PD and UE muscle strength had independent association with dextrous hand function at 6 months post-stroke. Stepwise multiple logistic regressions showed that the best early predictor was 2-PD in week 1 to 3 (Odds ratio [OR] ranged from 0.51-0.83) and UE muscle strength during the first 2 months post-stroke (OR ≥ 1.04). The strongest predictor was muscle strength at week 4 post-stroke, followed by combined 2-PD and muscle strength at week 2 post-stroke. Conclusions. Muscle strength and 2-PD in the paretic UE during the first month post-stroke were the best predictors of dextrous hand function recovery at 6 months.
ISSN:0963-8288
1464-5165
DOI:10.1080/09638280802061878