Recovery of the upper limb post ischaemic stroke and the predictive value of the Orpington Prognostic Score.
OBJECTIVE
To document upper limb recovery in stroke patients and investigate whether the Orpington Prognostic Score (OPS) performed within 48 hours of admission to hospital post ischaemic stroke was a predictor of upper limb function at six months and two years.


METHODS
Inception cohort design.


METHODS
Teaching Hospital.


METHODS
One hundred and fourteen patients hospitalized with acute ischaemic stroke were stratified into three groups based on their OPS within 48 hours of admission post stroke and underwent further assessments at two weeks, six months and two years after stroke onset.


METHODS
Rivermead Arm Score (RAS), Nine Hole Peg Test (NHPT) and grip strength (GS).


RESULTS
Patients with a good OPS and intermediate OPS showed significant recovery in all outcome measures for up to six months post stroke (p < 0.05), while those with a poor OPS at 48 hours showed no significant improvement (p > 0.05). The OPS score at 48 hours was the most highly correlated variable with upper limb outcome at six months (r= -0.728) and at two years (r= -0.712) compared with other variables such as age, class of stroke, sensation, grip strength and RAS.


CONCLUSIONS
Stroke patients demonstrate differential upper limb recovery patterns which need to be taken in consideration when designing studies that investigate efficacy of rehabilitation, and the OPS is highly correlated with upper limb recovery at six months and two years.
Meldrum
Dara
D
Beaumont Hospital, Dublin, Ireland. dmeldrum@rcsi.ie
Pittock
Sean J
SJ
Hardiman
Orla
O
Ni Dhuill
Caoimhe
C
O'Regan
Myra
M
D000368:Aged; D001132:Arm / Q000503:physiopathology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D020127:Recovery of Function; D020521:Stroke / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D013997:Time Factors; D016896:Treatment Outcome