Background: Age is one of the many factors that can influence functional improvement and activities of daily living (ADL) after a stroke. We looked at the effects of functional improvement of hemiplegic upper extremity (HUE) on ADL according to age in stroke patients. Methods: We recruited 46 stroke patients beginning acute or subacute rehabilitation. They were classified into two groups according to age, the elderly group (≥65 years, n=18) and the young group (<65 years, n=28). We performed the Pedretti clinical test for sensory evaluation of the upper extremity, the manual function test (MFT) to exam the motor function, and the functional independence measure (FIM) to assess ADL. Results: Sensory changes to HUE correlated significantly with eating, dressing-lower body, and toileting (self-care subitem) (p<0.05). Motor changes to HUE correlated significantly with dressing-upper body and toileting (self-care sub-item) (p<0.05). Prior to beginning rehabilitation, there were significant differences in sensory and motor functions of HUE between the two groups (p<0.05) but no significant difference in FIM (p>0.05). There were no significant differences in the changes to Pedretti clinical test, MFT, and FIM between the two groups before and after rehabilitation (p>0.05). In the young group, the motor improvement of HUE correlated significantly with FIM (p<0.05). In the elderly group, however, the sensory improvement and motor improvement of HUE were not correlated with FIM (p>0.05). Conclusion: In our study, elderly stroke patients showed improvement in function and ADL similar to young stroke patients. This potential should be maximized and elderly stroke patients should receive active rehabilitation.

A 49-year-old man received prolotherapy in the upper cervical region at a local medical clinic. Immediately after the procedure, he felt a sensation resembling an electric shock in his right upper and lower extremities, and continuously complained of numbness and discomfort in the right hemibody. He visited our clinic a week later. Upon physical examination, there were no significant abnormal findings. The visual analog scale was 60 points. T2-weight magnetic resonance images of the cervical spine showed a 0.7 cm sized bright oval spot on the right side of the spinal cord at the level of C4-C5 disc, suggesting spinal cord injury. There were no definite electrodiagnostic abnormalities. Digital infrared thermal images showed moderately decreased surface temperature on lateral aspect of the right forearm and dorsum of the right hand compared with the other side. Considering that very rare complications like spinal cord injury may develop after prolotherapy, we suggest that special interventions such as prolotherapy be performed by professional experts.