http://onlinelibrary.wiley.com/doi/10.1111/j.1747-4949.2012.00967.x/abstract
Version of Record online: 24 DEC 2012
DOI: 10.1111/j.1747-4949.2012.00967.x
© 2012 The Authors. International Journal of Stroke © 2012 World Stroke Organization
Additional Information(Show All)
- Conflict of interest: None declared.
- Abstract
- Article
- References
- Cited By
Keywords:
- activities;
- prognosis;
- stroke
Abstract
Knowledge
about factors that determine the final outcome after stroke is
important for early stroke management, rehabilitation goals, and
discharge planning. This narrative review provides an overview of
current knowledge about the prediction of activities after stroke. We
reviewed the pattern of stroke recovery for functions and activities,
the impact of spontaneous recovery on activities, and the measurement of
improvement in general. We explored the activities profiles during the
chronic phase and predictors for activities of daily living independence
after stroke, and finally, we discussed where to from here?
Mathematical regularities explain the nonlinear patterns of recovery,
making the outcome of activities of daily living highly predictable.
Initial severity of disability and extent of improvement observed within
the first weeks poststroke are important indicators of the outcome at
six-months. The sequence of progress in activities is almost fixed in
time. Studies showed that most motor recovery is almost completed within
10 weeks poststroke. On average, stroke recovery plateaus three- to
six-months after onset. Strong evidence was found that age and scores on
scales assessing severity of neurological deficits in the early
poststroke phase are strongly associated with the final basic activities
of daily living outcome after three-months poststroke. The validated
prediction models using simple algorithms, such as National Institutes
of Health Stroke Scale or Barthel Index, need to be implemented in
rehabilitation services and used for stratifying stroke patients in
trials. Future studies should investigate the accuracy of dynamic models
that includes time poststroke to optimize the application of prediction
rules in individuals with stroke.
No comments:
Post a Comment