Predicting recovery of dextrous hand function in acute stroke.
OBJECTIVE
To determine the clinical characteristics during acute stroke that predicted dextrous function in the paretic hand at 6 months post-stroke.


METHODS
Fifty-seven patients within 5 days post-stroke were recruited in stroke wards. Recovery of dextrous hand function, indicated by a score of > or =35 of Action Research Arm Test, was assessed weekly in the first 4 weeks then monthly till 6 months post-stroke. The seven predictor candidates evaluated included side and site of brain infarct, stroke severity, cognition, spatial neglect, two-point discrimination (2-PD), muscle tone and muscle strength of the paretic upper extremity (UE).


RESULTS
Site of infarct, stroke severity, 2-PD and UE muscle strength had independent association with dextrous hand function at 6 months post-stroke. Stepwise multiple logistic regressions showed that the best early predictor was 2-PD in week 1 to 3 (Odds ratio [OR] ranged from 0.51-0.83) and UE muscle strength during the first 2 months post-stroke (OR > or = 1.04). The strongest predictor was muscle strength at week 4 post-stroke, followed by combined 2-PD and muscle strength at week 2 post-stroke.


CONCLUSIONS
Muscle strength and 2-PD in the paretic UE during the first month post-stroke were the best predictors of dextrous hand function recovery at 6 months.
Au-Yeung
Stephanie S Y
SS
Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, SAR, China.
Hui-Chan
Christina W Y
CW
D000368:Aged; D004185:Disability Evaluation; D005260:Female; D006225:Hand / Q000503:physiopathology*; D018737:Hand Strength; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009048:Motor Skills; D016017:Odds Ratio; D010291:Paresis / Q000534:rehabilitation; D011446:Prospective Studies; D012372:ROC Curve; D020127:Recovery of Function; D020521:Stroke / Q000503:physiopathology*; D000071939:Stroke Rehabilitation