Predicting Recovery of Upper Extremity Motor Function After Stroke According to the NovEl Intervention Using Repetitive Transcranial Magnetic Stimulation and Occupational Therapy: NEURO

Abstract

Background: To encourage patient goal setting and active participation in their own rehabilitation, physicians should provide patients with evidence-based prognostic predictions. Objective: This study aimed to analyze whether logarithmic time series changes in the Fugl-Meyer Assessment (FMA) score of the upper extremity (from treatment to one month after treatment) owing to NovEl intervention using repetitive transcranial magnetic stimulation and intensive occupational therapy (NEURO) conformed to logarithmic model formulae (group level), and whether the FMA score could be predicted by applying pre/posttreatment FMA scores following the model equation (individual level). Methods: This retrospective, longitudinal study included 514 poststroke paralysis patients admitted to our hospital between March 2010 and December 2018. FMA scores at 3 time points (before, after, and 4 weeks after treatment) were assessed, and conventional logarithmic regression analyses were performed to determine the time course of motor recovery. Subjects were randomly divided into 2 groups in derivation ( n = 257) and validation ( n = 257) analysis. Results: The time series change in the FMA score correlated with logarithmic model formulae ( r2 = .97). The FMA score was substituted for the logarithmic formulae, and individual FMA scores (4 weeks after NEURO treatment) were predicted. The r2 value between the predicted and measured FMA scores was .65. Conclusions: The logarithmic model based on FMA scores before and after NEURO treatment individually predicted approximately 65% of FMA scores 4 weeks after treatment. NEURO allows the physicians to explain the prognosis to individual patients so that they can participate in their rehabilitation practices and achieve their goals.