Six-month functional recovery of stroke patients

Abstract

The aim of this study is to compare the time-course changes in neurologic impairments (trunk control, motor function, sensory, and cognition) and recovery in functional impairments (activity of daily livings and gait) simultaneously from initiating rehabilitation to 6 months after stroke. Consecutive stroke patients were recruited from the department of nervous surgery, and transferred into the department of rehabilitation medicine and continued on treatment during the acute stage. Outcome measures were examined at the initial rehabilitation baseline, 1, 2, and 4 weeks after rehabilitation treatment, and 3, 4, 5, and 6 months after stroke. Patients were assessed using the Trunk Impairment Scale, the Fugl-Meyer Motor and Sensory Assessments for the upper and lower limbs, Mini-Mental State Examination, Functional Ambulation Category, and Modified Barthel Index. Twenty consecutive patients were analyzed in the study with complete assessments. The recovery was relatively rapid during the 4 weeks after treatment (P value ranges from <0.001 to <0.007) and then to a lesser extent decelerated between 3 and 6 months after stroke (P value between <0.001 and 0.080). Statistical comparison by repeated measures analysis showed a significant interaction between time points and measures of all recovery variables (P<0.001). Significant differences in level of impairments and functional recovery were found at the different time points. In comparison with the lower leg and trunk control, the upper arm showed less recovery, with a significant difference. All variables except for leg motor function improved continuously over 6 months after stroke. Nevertheless, this study confirms the importance of the period within 3 months for recovery after stroke, during which most of the recovery occurred, ranging from 48 to 91%. Therefore, intensive treatment targeting motor and sensory functions early after stroke may be beneficial for recovery of impairments and functional performance.

Prognosis and Recovery of Motor Function with Lesion–Symptom Mapping in Patients with Stroke

“…Between 3 and 6 months after stroke, most previous studies report little or no observable recovery [5,7]. In contrast, Lee et al [6] showed a small but significant improvement in all recovery variables 3-6 months after a stroke, with the exception of lower-body motor function, indicating that recovery had not yet plateaued. In addition, it is known that most of the recovery of gait and motor function generally occurs within 6 months after a stroke [8,9].…”

“…Improvement in motor function in the lower body is observed in -65% of patients with initial motor deficits [3]; however, the probability of recovery of normal functioning in the upper limbs is much lower (< 15%) [4]. Additionally, the rate of clinical recovery is relatively rapid during the first few weeks after a stroke, and then decelerates 1-3 months later [5,6]. Between 3 and 6 months after stroke, most previous studies report little or no observable recovery [5,7].…”

“…For this reason, the analysis of recovery profiles is important because this information can help to provide more specific plans for stroke rehabilitation [11]. Several investigators have studied clinical post-stroke recovery, mostly in terms of upper and lower motor function, gait, balance, cognition, trunk control, and activities of daily living (ADL) [6,7,9,[12][13][14][15][16][17][18][19][20][21]. Our knowledge of the details of stroke recovery remains limited, and there are few validated predictors of clinical recovery and generally insufficient data on the degree of recovery that can be achieved.…”

Thrombectomy versus medical management for large vessel occlusion strokes with minimal symptoms: an analysis from STOPStroke and GESTOR cohorts

“…The different follow-up time points (3 months for the interventional group vs 6 months for the medical therapy group) should not have a significant influence on the study results considering that (1) the primary analysis was discharge outcome and (2) the theoretical advantage of more recovery time should have favored the medical therapy group 15. It should be noted that the groups derived from different cohorts and study periods; the advancements in medical management over time might have played an important role in the study results.…”

Cognitive and Functional Outcomes following Inpatient Rehabilitation in Patients with Acquired Brain Injury: A Prospective Follow-up Study

“…[16383940] Tatemichi et al . demonstrated a substantial body of high-quality research evidence for the effectiveness and cost-effectiveness of rehabilitation in patients with ABI.…”