Do you not understand, recovery prediction is useless for stroke survivors? It does nothing to get them recovered. And all you're going to tell them is they won't fully recover. They need to sue you for malpractice for such incompetence! I'd have you all fired!
Predicting motor recovery of the upper limb after stroke rehabilitation: value of a clinical examination
HILDE FEYS, WILLY DE WEERDT, GODELIEVE NUYENS and ANN VAN DE
WINCKEL Department of Rehabilitation Sciences, University of Leuven, Belgium
BEAT SELZ Department of Rehabilitation and Geriatric Medicine, Bürgerspital,
Switzerland
CARLOTTE KIEKENS Department of Physical Medicine and Rehabilitation,
University Hospital, Leuven, Belgium
ABSTRACT
Background and Purpose.
Only a few studies have been conducted to
predict motor recovery of the arm after stroke. The aims of this study were to identify which
clinical variables, assessed at different points in time, were predictive of motor recovery,
and to construct useful regression equations. (Why the fuck do this? It won't get survivors recovered, will it? But it did get you published, so there's that; that doesn't help survivors, does it?)
Method.
One hundred consecutive stroke
patients who had an obvious motor deficit of the upper limb were evaluated on entry to the
study (two to five weeks post-stroke) and at two, six and 12 months after stroke. The
Brunnström–Fugl-Meyer test was used as the outcome measure. Predictors included demo-
graphic data, overall disability, clinical neurological features, neuropsychological factors and
secondary shoulder complications.
Results.
In multiple regression analyses, motor performance was invariably retained as the predictive factor with the highest R-square. Other significant predictive variables were overall disability, muscle tone, proprioception and
hemi-inattention. Between 53% and 89% of the total amount of variance was accounted
for in all selected models. The accuracy of prediction from clinical measurement in the
acute phase diminished as the time span of measurement of outcome increased. Similarly,
assessment of the variables at two and six months, rather than in the acute stage, resulted in
a considerable improvement in the percentage variance explained at 12 months. The highest
accuracy was obtained when predictions were made step-by-step in time.
Conclusions.
It
is possible to predict motor recovery of the upper limb accurately through the use of a few
clinical measures. Predictive equations are proposed, the use of which are practicable in
both clinical practice and research.
