Arm and leg paresis as outcome predictors in stroke rehabilitation.

Abstract

I used leg and arm paresis to predict outcome measured as extremity function in a prospective study of 75 consecutive hemiplegic patients admitted to an inpatient stroke rehabilitation unit. In each patient, extremity paresis was quantified according to the five-point scoring system advised by the Medical Research Council, upper extremity function was quantified using the Barthel Index subscore for feeding and dressing the upper body, and lower extremity function was quantified according to a five-point scoring of the ability to walk. Improvement was recorded for upper extremity function in 52% of the patients and for lower extremity function in 89%. Best extremity function was reached a mean±SEM of 9±3 and 10±4 weeks after stroke for the upper and lower extremities, respectively. In patients experiencing complete recovery, this occurred a mean±SEM of 7±2 weeks (for both upper and lower extremities) after the stroke. Only 8-11% of the patients with paresis scores of ^2 regained independent extremity function after rehabilitation. Half of the patients with paresis scores of ^3 regained independent extremity function after rehabilitation, while the other half were able to perform extremity function with only minimal assistance. As predictors of extremity function, the Barthel Index subscore was slightly better (r=0.64) than paresis score (r=0.58). However, because evaluation of extremity paresis is easy, it appears to be useful as a preliminary predictor of outcome following stroke. (Stroke 1990;21:247-251)

Post-stroke motor and functional evaluations: a clinical correlation using Fugl-Meyer assessment scale, Berg balance scale and Barthel index

“…Regarding to UL graduation in the Barthel Index, Olsen suggests that the functional improvement of patients with severe post-stroke impairment may probably be attributed to the use of compensatory strategies involving the non-paretic limb 9 . In other words, it does not matter how the patient performs the task; the important thing is for him/her to perform it regardless of the use of compensatory strategies or not.…”

Effects of Mirror Therapy on Subacute Stroke Patients’ Brain Waves and Upper Extremity Functions

“…Eighty-five percent of stroke patients experience upper extremity motor dysfunction 1) . They do not precisely know what their motor ability is and tend to have a negative perception about it.…”

Effect of Robot-Assisted Hand Rehabilitation on Hand Function in Chronic Stroke Patients

“…발병 초기 뇌졸중 환자의 다수가 상지 기능에 장애를 보이며, 절반 이상이 발병 3-6개월 후에도 상지기능 에 문제를 보인다고 하였다 [2] . 뇌졸중 환자 치료에 있어서 최근의 경향은 뇌가소성을 이론을 바탕으로 한 강제유도운동치료, 전기적 뇌자극, 상 상연습훈련, 거울치료, 가상현실치료, 로봇보조치료 등이 있다 [3] .…”