title: Correlation between ambulatory function and clinical factors in hemiplegic patients with intact single lateral corticospinal tract: A pilot study.
abstract: To define the relationship between the complete destruction of 1 lateral corticospinal tract (CST), as demonstrated by diffusion tensor imaging (DTI) tractography, and ambulatory function 6 months following stroke.Twenty-six adults (17 male, 9 female) with poststroke hemiplegia who were transferred to the physical medicine and rehabilitation department. Participants underwent DTI tractography, which showed that 1 lateral CST had been clearly destroyed.Functional ambulation classification (FAC) scores at admission, discharge, and 6 months after discharge were used to evaluate the patients' ability to walk. The National Institutes of Health Stroke Scale (NIHSS) and the Korean version of the modified Barthel index (K-MBI) at admission, discharge, and 6 months after discharge were used to evaluate the degree of functional recovery.Of the 26 patients, 18 were nonambulatory (FAC level 1-3), and 8 were able to walk without support (FAC level 4-6). The type of stroke (infarction or hemorrhage), site of the lesion, spasticity of lower extremities, cranioplasty, and the time taken from onset to MRI were not statistically significantly correlated with the ability to walk. However, statistically significant correlations were found in relation to age, K-MBI scores, and initial NIHSS scores.Despite the complete damage to the lesion site and the preservation of 1 unilateral CST, as shown by DTI, good outcomes can be predicted on the basis of younger age, low NIHSS scores, and high MBI scores at onset.
authors: Department of Physical Medicine and Rehabilitation, National Health Insurance Service Ilsan Hospital, Goyang, Korea.
authors: Ji Seong
authors: JS
authors: Hong
authors: Jong Moon
authors: JM
authors: Kim
authors: Hyoung Seop
authors: HS
authors: Kim
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D056324:Diffusion Tensor Imaging / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D020233:Gait Disorders, Neurologic / Q000209:etiology / Q000503:physiopathology* / Q000534:rehabilitation; D006429:Hemiplegia / Q000175:diagnosis* / Q000209:etiology / Q000534:rehabilitation*; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011712:Pyramidal Tracts / Q000473:pathology*; D020127:Recovery of Function; D012047:Rehabilitation Centers; D012189:Retrospective Studies; D018570:Risk Assessment; D020521:Stroke / Q000150:complications* / Q000175:diagnosis; D016896:Treatment Outcome; D016138:Walking / Q000502:physiology*