Predictors for early motor improvement in patients with ischemic stroke

Abstract

Disability as a stroke consequence is reported by 3% males and 2% females in general population. Motor deficits are common in stroke patients, but their complete recovery is seen only in a minority of cases. Assessment of motor deficits uses clinical methods, especially standardized scales, but also electrophysiological and imagistic methods. The motor recovery is a continuous process, maximal in the first month after stroke, decreasing gradually over the first 6 months. Most powerful predictors for motor recovery are clinical parameters: severity of motor deficit, onset of first voluntary movements after stroke in the first 48-72 hours, a continuous improvement in motor function during the first 8 weeks, a good postural control during the first month, young age, male sex, left hemispheric stroke and absence of other neurological impairments are strong positive predictors. Presence of motor-evoked potentials in paretic muscles and imagistic parameters as location, stroke volume and motor pathways integrity are paraclinical predictors for recovery. There are no specific biomarker which is efficient in predicting recovery. In patients with poor chances for recovery according to actual predictors, the development of more precise algorithms to assess functional outcome is needed, in order to support the choice of appropriate methods and intensity of rehabilitation treatment. Key words: ischemic stroke rehabilitation, functional assessment, motor improvement, recovery predictors, prognostic factors,

Diagnostic particularities and multimodal therapeutic and rehabilitation approches to a complex case of post ischemic stroke with dyshphagia and dysphonia, associating Millard-Gubler and Wallenberg syndromes- case report

“…MGS manifests as ipsilateral palsy of CN VI and VII with contralateral hemiplegia (8). Motor deficits in strokes are common, being caused by lesions of the motor areas and pyramidal tract (corticospinal tract originate from pyramidal cells for MGS) (9). The diagnosis of MGS is confirmed by clinical examination, reinforced by neurological imaging (computed tomography and magnetic resonance imaging) for identifying the lesion.…”

The effect of stretching exercises as part of the rehabilitation program for patients with spinal cord injury

“…Spasticity is defined as a velocity-dependent increase in the tonic stretch reflex resulting in hypertonia of the deficient muscles. Spasticity develops progressively over the months following an injury, after a period of spinal shock, characterized by loss of tendon reflexes below the level of the lesion, motor deficit (paralysis) and hypotonia (2,(5)(6)(7)(8)(9). Spasticity can be both beneficial and non-beneficial, and requires treatment when it causes significant impairments and complications.…”