I hate the term they use - realistic rehabilitation goal-setting- they've already conceded that they aren't even trying for any recovery beyond the normal spontaneous recovery. We have to call them out on their backwards thinking, so send them an email. I will.
Correspondence to: Professor Winston Byblow, Department of Sport and Exercise Science and Centre for Brain Research, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand E-mail: w.byblow@auckland.ac.nz
http://brain.oxfordjournals.org/content/135/8/2527
Summary
Stroke is a leading cause of adult
disability and the recovery of motor function is important for
independence in activities
of daily living. Predicting motor recovery after
stroke in individual patients is difficult. Accurate prognosis would
enable
realistic rehabilitation goal-setting and more
efficient allocation of resources. The aim of this study was to test and
refine
an algorithm for predicting the potential for
recovery of upper limb function after stroke. Forty participants were
prospectively
enrolled within 3 days of ischaemic stroke. First,
shoulder abduction and finger extension strength were graded 72 h after
stroke onset to compute a shoulder abduction and
finger extension score. Secondly, transcranial magnetic stimulation was
used
to assess the functional integrity of descending
motor pathways to the affected upper limb. Third, diffusion-weighted
magnetic
resonance imaging was used to assess the structural
integrity of the posterior limbs of the internal capsules. Finally,
these
measures were combined in the PREP algorithm for
predicting an individual’s potential for upper limb recovery at 12
weeks,
measured with the Action Research Arm Test. A
cluster analysis was used to independently group patients according to
Action
Research Arm Test score at 12 weeks, for comparison
with predictions from the PREP algorithm. There was excellent
correspondence
between the cluster analysis of Action Research Arm
Test score at 12 weeks and predictions made with the PREP algorithm.
The
algorithm had positive predictive power of 88%,
negative predictive power of 83%, specificity of 88% and sensitivity of
73%.
This study provides preliminary data in support of
the PREP algorithm for the prognosis of upper limb recovery in
individual
patients. PREP may enable tailored planning of
rehabilitation and more accurate stratification(triage anyone) of patients in clinical
trials.
Bring out ze dead brains.
But I'm not recovered yet, don't toss me on the wagon
Bring out ze dead brains.
But I'm not recovered yet, don't toss me on the wagon
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