Predictive factors of upper limb motor recovery for stroke survivors admitted to a rehabilitation program.

BACKGROUND

Various factors may interact with functional gains from upper limb motor training in patients with stroke.

AIM

This study aimed to explore the predictors of upper limb motor recovery in patients with stroke who were admitted to a rehabilitation program.

DESIGN

A retrospective, longitudinal observational study was conducted to evaluate the change in Fugl-Meyer assessment upper extremity Score (FMA-UE) at admission and 15 and 30 days after admission.

SETTING

Setting of the study was a rehabilitation hospital.

POPULATION

Patients received rehabilitation training during the study period.

METHODS

Demographic information and clinical factors were collected as independent variables. Longitudinal analysis of UE motor recovery measured by FMA-UE over time was performed using the mixed-effects model.

RESULTS

Data from 110 participants were included. FMA-UE score showed significant increase (β=4.12, P<0.001). Cognitive functions assessed by the Montreal Cognitive Assessment (MoCA) positively correlated with the improvement in UE functions (β=0.13, P<0.001), while time since stroke negatively correlated with improvement across time (β=-0.05, P=0.019). Patients with subcortical lesions improved faster than those with mixed cortical and subcortical lesions did (difference in slope =2.83, P=0.001). Improvement in patients with moderately impaired UE motor functions was faster than in those with severely impaired UE motor functions (difference in slope =2.74, P=0.016). Severity of hemiplegia, MoCA, and time since stroke were significant predictors in multivariable, mixed-effects models.

CONCLUSIONS

Initial motor and cognitive impairments may be associated with UE motor recovery in patients admitted to a rehabilitation program.

CLINICAL REHABILITATION IMPACT

Early assessments of motor and cognitive impairments after stroke would contribute to the prediction of UE motor recovery in patients admitted to a rehabilitation program. The information would also help the stratification of patients for poststroke upper limb rehabilitation trials.