Prediction of Upper Limb use Three Months after Stroke: A Prospective Longitudinal Study

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Prediction of Upper Limb use Three Months after Stroke : A Prospective Longitudinal Study. / Lundquist, Camilla Biering; Nielsen, Jørgen Feldbæk; Brunner, Iris Charlotte.

I: Journal of stroke and cerebrovascular diseases, Bind 30, Nr. 11, 106025, 11.2021.

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

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Lundquist CB, Nielsen JF, Brunner IC. Prediction of Upper Limb use Three Months after Stroke: A Prospective Longitudinal Study. Journal of stroke and cerebrovascular diseases. 2021 nov.;30(11):106025. doi: 10.1016/j.jstrokecerebrovasdis.2021.106025

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@article{459c57f4be954f2b9412992ee557e455,
title = "Prediction of Upper Limb use Three Months after Stroke: A Prospective Longitudinal Study",
abstract = "Background: A major goal of upper limb (UL) rehabilitation after stroke is to facilitate the use of the paretic arm in daily life activities. Purpose: To examine if UL impairment two weeks after stroke can predict real-life UL use at three months. Furthermore, to identify additional factors which contribute to future UL use, and characteristics of patients who do not achieve normal UL use. Methods: This study included patients with stroke ≥ 18 years. UL impairment was assessed by Fugl-Meyer upper extremity motor assessment (FM). Use ratio between affected and unaffected UL was assessed with accelerometers at three months after stroke. The association between FM score and UL use ratio was investigated with linear regression models and adjusted for secondary variables. Non-normal use was examined by a logistic regression. Results: Eighty-seven patients were included. FM score two weeks after stroke predicted 38% of the variance in UL use ratio three months after stroke. A multivariate regression model predicted 55%, and the significant predictors were FM, motor-evoked potential (MEP) status, and neglect. Non-normal use could be predicted with a high accuracy based on MEP and/or neglect. In a logistic regression sensitivity for prediction of non-normal use was 0.93 and specificity was 0.75. Conclusion: Better baseline capacity of the paretic UL predicted increased use of the arm and hand in daily life. Non-normal UL use could be predicted reliably based on the absence of MEPs and/or presence of neglect.",
keywords = "Accelerometers, Prediction, biomarker, Prognosis, Rehabilitation, Stroke, Upper extremity",
author = "Lundquist, {Camilla Biering} and Nielsen, {J{\o}rgen Feldb{\ae}k} and Brunner, {Iris Charlotte}",
note = "Publisher Copyright: {\textcopyright} 2021 Elsevier Inc.",
year = "2021",
month = nov,
doi = "10.1016/j.jstrokecerebrovasdis.2021.106025",
language = "English",
volume = "30",
journal = "Journal of Stroke & Cerebrovascular Diseases",
issn = "1052-3057",
publisher = "W.B. Saunders Co.",
number = "11",

}

RIS

TY - JOUR

T1 - Prediction of Upper Limb use Three Months after Stroke

T2 - A Prospective Longitudinal Study

AU - Lundquist, Camilla Biering

AU - Nielsen, Jørgen Feldbæk

AU - Brunner, Iris Charlotte

N1 - Publisher Copyright: © 2021 Elsevier Inc.

PY - 2021/11

Y1 - 2021/11

N2 - Background: A major goal of upper limb (UL) rehabilitation after stroke is to facilitate the use of the paretic arm in daily life activities. Purpose: To examine if UL impairment two weeks after stroke can predict real-life UL use at three months. Furthermore, to identify additional factors which contribute to future UL use, and characteristics of patients who do not achieve normal UL use. Methods: This study included patients with stroke ≥ 18 years. UL impairment was assessed by Fugl-Meyer upper extremity motor assessment (FM). Use ratio between affected and unaffected UL was assessed with accelerometers at three months after stroke. The association between FM score and UL use ratio was investigated with linear regression models and adjusted for secondary variables. Non-normal use was examined by a logistic regression. Results: Eighty-seven patients were included. FM score two weeks after stroke predicted 38% of the variance in UL use ratio three months after stroke. A multivariate regression model predicted 55%, and the significant predictors were FM, motor-evoked potential (MEP) status, and neglect. Non-normal use could be predicted with a high accuracy based on MEP and/or neglect. In a logistic regression sensitivity for prediction of non-normal use was 0.93 and specificity was 0.75. Conclusion: Better baseline capacity of the paretic UL predicted increased use of the arm and hand in daily life. Non-normal UL use could be predicted reliably based on the absence of MEPs and/or presence of neglect.

AB - Background: A major goal of upper limb (UL) rehabilitation after stroke is to facilitate the use of the paretic arm in daily life activities. Purpose: To examine if UL impairment two weeks after stroke can predict real-life UL use at three months. Furthermore, to identify additional factors which contribute to future UL use, and characteristics of patients who do not achieve normal UL use. Methods: This study included patients with stroke ≥ 18 years. UL impairment was assessed by Fugl-Meyer upper extremity motor assessment (FM). Use ratio between affected and unaffected UL was assessed with accelerometers at three months after stroke. The association between FM score and UL use ratio was investigated with linear regression models and adjusted for secondary variables. Non-normal use was examined by a logistic regression. Results: Eighty-seven patients were included. FM score two weeks after stroke predicted 38% of the variance in UL use ratio three months after stroke. A multivariate regression model predicted 55%, and the significant predictors were FM, motor-evoked potential (MEP) status, and neglect. Non-normal use could be predicted with a high accuracy based on MEP and/or neglect. In a logistic regression sensitivity for prediction of non-normal use was 0.93 and specificity was 0.75. Conclusion: Better baseline capacity of the paretic UL predicted increased use of the arm and hand in daily life. Non-normal UL use could be predicted reliably based on the absence of MEPs and/or presence of neglect.

KW - Accelerometers

KW - Prediction, biomarker

KW - Prognosis

KW - Rehabilitation

KW - Stroke

KW - Upper extremity

UR - http://www.scopus.com/inward/record.url?scp=85113729182&partnerID=8YFLogxK

U2 - 10.1016/j.jstrokecerebrovasdis.2021.106025

DO - 10.1016/j.jstrokecerebrovasdis.2021.106025

M3 - Journal article

C2 - 34464925

AN - SCOPUS:85113729182

VL - 30

JO - Journal of Stroke & Cerebrovascular Diseases

JF - Journal of Stroke & Cerebrovascular Diseases

SN - 1052-3057

IS - 11

M1 - 106025

ER -