title: The crossed leg sign indicates a favorable outcome after severe stroke.
abstract: OBJECTIVE
  We investigated whether crossed legs are a prognostic marker in patients with severe stroke.
  
  
  METHODS
  In this controlled prospective observational study, we observed patients with severe stroke who crossed their legs during their hospital stay and matched them with randomly selected severe stroke patients who did not cross their legs. The patients were evaluated upon admission, on the day of leg crossing, upon discharge, and at 1 year after discharge. The Glasgow Coma Scale, the NIH Stroke Scale (NIHSS), the modified Rankin Scale (mRS), and the Barthel Index (BI) were obtained.
  
  
  RESULTS
  Patients who crossed their legs (n = 34) and matched controls (n = 34) did not differ in any scale upon admission. At the time of discharge, the GCS did not differ, but the NIHSS was better in crossed legs patients (6.5 vs 10.6; p = 0.0026), as was the mRS (3.4 vs 5.1, p < 0.001), and the BI (34.0 vs 21.1; p = 0.0073). At 1-year follow-up, mRS (2.9 vs 5.1, p < 0.001) and the BI (71.3 vs 49.2; p = 0.045) were also better in the crossed leg group. The mortality between the groups differed grossly; only 1 patient died in the crossing group compared to 18 in the noncrossing group (p < 0.001).
  
  
  CONCLUSIONS
  Leg crossing is an easily obtained clinical sign and is independent of additional technical examinations. Leg crossing within the first 15 days after severe stroke indicates a favorable outcome which includes less neurologic deficits, better independence in daily life, and lower rates of death.
authors: Department of Neurology, University of Munich, Munich, Germany.
authors: J
authors: J
authors: Rémi
authors: T
authors: T
authors: Pfefferkorn
authors: R L
authors: RL
authors: Owens
authors: C
authors: C
authors: Schankin
authors: S
authors: S
authors: Dehning
authors: T
authors: T
authors: Birnbaum
authors: A
authors: A
authors: Bender
authors: M
authors: M
authors: Klein
authors: J
authors: J
authors: Adamec
authors: H-W
authors: HW
authors: Pfister
authors: A
authors: A
authors: Straube
authors: B
authors: B
authors: Feddersen
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D015600:Glasgow Coma Scale; D006760:Hospitalization; D006801:Humans; D007866:Leg / Q000503:physiopathology*; D008297:Male; D019370:Observation; D017063:Outcome Assessment, Health Care; D011379:Prognosis; D011446:Prospective Studies; D012189:Retrospective Studies; D012720:Severity of Illness Index; D020521:Stroke / Q000175:diagnosis* / Q000503:physiopathology*