Predictors of movement recovery after stroke

This study examined predictive factors of regaining upper limb (arm and hand) movement in stroke patients. The authors concluded that voluntary finger extension (lifting) 4 to 8 weeks after stroke is a good indication for regaining upper limb movement within 6 months.

Many stroke patients lose some ability to move. Movement of the hands and arms (upper limbs) is most frequently affected. Voluntary finger extension (VFE) refers to being able to lift an individual finger at will. VFE has previously been shown to be a good indicator of movement recovery. There has been little evidence, however, to define a time window of regaining VFE. Whether patients who regain VFE later after stroke are still able to regain upper limb movement has not been fully studied.

This study aimed to identify a time window of the return of VFE as well as other patient factors that may increase the likelihood of upper limb movement recovery.

100 patients who had experienced their first stroke and who showed no sign of VFE within 4 to 12 days after stroke were included in this study. VFE was measured in the first 5 weeks after stroke and at 8, 12 and 26 weeks. The recovery of upper limb movement was tested at 6 months with a specific set of hand and arm movement tasks.

45 patients recovered upper limb movement after 6 months. 51% of these patients regained VFE within 4 weeks. 84% of patients regained VFE within 8 weeks.

Patients without visuospatial neglect (a condition of visual inattention caused by stroke) were more likely to regain movement. Patients with good touch and sensory function were also more likely to regain movement. Good movement ability of the legs (based on range of motion) was another indicator of upper limb movement recovery. Patients with all 3 of these factors had a probability of 94% to regain upper limb movements at 6 months.

The authors concluded that VFE between 4 and 8 weeks after stroke was a significant predictor of upper limb movement recovery at 6 months. The absence of visuospatial neglect, good touch and sensory function, as well as good leg movements were also significant predictors.

This study used patients after their first stroke. Results may not be the same for patients with recurring stroke.