title: Is it possible to accurately predict outcome of a drop-foot in patients admitted to a hospital stroke unit?
abstract: The aim of this study was to determine whether recovery from a drop-foot at 6 months can be predicted within 72 h after stroke and to investigate the effect of timing on the accuracy of prediction. One hundred and five patients with a first-ever anterior circulation stroke without full voluntary ankle dorsiflexion in standing position following the Fugl-Meyer motor score at 72 h were included for further analysis. Determinants were measured within 72 h, and at days 5 and 9 after stroke onset. Multivariable logistic regression analysis was used to predict the recovery of full ankle dorsiflexion while standing at 6 months. Having the item 'Motricity Index ankle dorsiflexion 19 or more (full range of motion ankle dorsiflexion againsts gravity)' was the best predictive variable. The sensitivity was 0.74 [95% confidence interval (CI) 0.62-0.80], specificity was 0.72 (95% CI 0.62-0.81), positive predictive value was 0.74 (95% CI 0.63-0.82), and negative predictive value was 0.71 (95% CI 0.60-0.80). No significant changes at day 5 and 9 after stroke were found. In stroke patients, the presence of full ankle dorsiflexion against gravity within 72 h is an accurate predictor for the absence of a drop-foot at 6 months. The accuracy of prediction of true positives and negatives is irrespective of the time of assessment in a stroke unit.
authors.affiliation: aDepartment of Rehabilitation Medicine, MOVE Research Institute Amsterdam, VU University Medical Centre, Amsterdam, The Netherlands bUOP Professioni Della Riabilitazione, Azienda Ospedaliera Universitaria Senese, Siena, Italy cCentre of Excellence for Rehabilitation Medicine Utrecht, Rehabilitation Centre 'De Hoogstraat' and Rudolf Magnus Institute, University Medical Centre Utrecht, Utrecht, The Netherlands.
authors.forename: David
authors.initials: D
authors.lastname: Cioncoloni
authors.forename: Janne M
authors.initials: JM
authors.lastname: Veerbeek
authors.forename: Erwin E H
authors.initials: EE
authors.lastname: van Wegen
authors.forename: Gert
authors.initials: G
authors.lastname: Kwakkel
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D020233:Gait Disorders, Neurologic / Q000209:etiology / Q000534:rehabilitation*; D006757:Hospital Units; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D020127:Recovery of Function; D012680:Sensitivity and Specificity; D020521:Stroke / Q000150:complications; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome