Predictive factors of upper limb motor recovery for stroke survivors admitted to a rehabilitation program.

BACKGROUND

Various factors may interact with functional gains from upper limb motor training in patients with stroke.

AIM: This study aimed to explore the predictors of upper limb motor recovery in patients with stroke who were admitted to a rehabilitation program.

DESIGN

A retrospective, longitudinal observational study was conducted to evaluate the change in Fugl-Meyer assessment upper extremity Score (FMA-UE) at admission and 15 and 30 days after admission.

SETTING

Setting of the study was a rehabilitation hospital.

POPULATION: Patients received rehabilitation training during the study period.

METHODS

Demographic information and clinical factors were collected as independent variables. Longitudinal analysis of UE motor recovery measured by FMA-UE over time was performed using the mixed-effects model.

RESULTS

Data from 110 participants were included. FMA-UE score showed significant increase (β=4.12, P<0.001). Cognitive functions assessed by the Montreal Cognitive Assessment (MoCA) positively correlated with the improvement in UE functions (β=0.13, P<0.001), while time since stroke negatively correlated with improvement across time (β=-0.05, P=0.019). Patients with subcortical lesions improved faster than those with mixed cortical and subcortical lesions did (difference in slope =2.83, P=0.001). Improvement in patients with moderately impaired UE motor functions was faster than in those with severely impaired UE motor functions (difference in slope =2.74, P=0.016). Severity of hemiplegia, MoCA, and time since stroke were significant predictors in multivariable, mixed-effects models.

CONCLUSIONS

Initial motor and cognitive impairments may be associated with UE motor recovery in patients admitted to a rehabilitation program.

CLINICAL REHABILITATION IMPACT: Early assessments of motor and cognitive impairments after stroke would contribute to the prediction of UE motor recovery in patients admitted to a rehabilitation program. The information would also help the stratification of patients for poststroke upper limb rehabilitation trials.