Document Detail


Presence of finger extension and shoulder abduction within 72 hours after stroke predicts functional recovery: early prediction of functional outcome after stroke: the EPOS cohort study.
MedLine Citation:
PMID:  20167916     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: The aim of the present study was to determine if outcome in terms of upper limb function at 6 months after stroke can be predicted in hospital stroke units using clinical parameters measured within 72 hours after stroke. In addition, the effect of the timing of assessment after stroke on the accuracy of prediction was investigated by measurements on days 5 and 9. METHODS: Candidate determinants were measured in 188 stroke patients within 72 hours and at 5 and 9 days after stroke. Logistic regression analysis was used for model development to predict upper limb function at 6 months measured with the action research arm test (ARAT). RESULTS: Patients with an upper limb motor deficit who exhibit some voluntary extension of the fingers and some abduction of the hemiplegic shoulder on day 2 have a probability of 0.98 to regain some dexterity at 6 months, whereas the probability was 0.25 for those without this voluntary motor activity. Sixty percent of patients with some early finger extension achieved full recovery at 6 months in terms of action research arm test score. Retesting the model on days 5 and 9 resulted in a gradual decline in probability from 0.25 to 0.14 for those without voluntary motor activity of shoulder abduction and finger extension, whereas the probability remained 0.98 for those with this motor activity. CONCLUSIONS: Based on 2 simple bedside tests, finger extension and shoulder abduction, functional recovery of the hemiplegic arm at 6 months can be predicted early in a hospital stroke unit within 72 hours after stroke onset.
Authors:
Rinske H M Nijland; Erwin E H van Wegen; Barbara C Harmeling-van der Wel; Gert Kwakkel;
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-02-18
Journal Detail:
Title:  Stroke; a journal of cerebral circulation     Volume:  41     ISSN:  1524-4628     ISO Abbreviation:  Stroke     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-03-30     Completed Date:  2010-05-03     Revised Date:  2010-06-30    
Medline Journal Info:
Nlm Unique ID:  0235266     Medline TA:  Stroke     Country:  United States    
Other Details:
Languages:  eng     Pagination:  745-50     Citation Subset:  IM    
Affiliation:
Department of Rehabilitation Medicine, VU University Medical Centre, Amsterdam, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Disability Evaluation
Female
Fingers / physiology*
Hemiplegia / physiopathology,  rehabilitation
Hospital Units
Humans
Male
Middle Aged
Movement*
Predictive Value of Tests
Recovery of Function*
Regression Analysis
Shoulder / physiology*
Stroke* / physiopathology,  rehabilitation
Time Factors
Treatment Outcome
Investigator
Investigator/Affiliation:
G Kwakkel / ; B C Harmeling-van der Wel / ; J M Veerbeek / ; R H M Nijland / ; E E E van Wegen / ; M A van der Beek / ; W A M Cornelissen / ; A A G Goos / ; C S Steeg / ; J M Timmermans / ; R Tichelaar /
Comments/Corrections
Comment In:
Stroke. 2010 Jul;41(7):e466; author reply e467-8   [PMID:  20466992 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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