[Value of the MSH classification in the hemiplegic stroke patient]

The functional prognosis of patients should be known when planning their rehabilitation treatment.

To find the prognostic value of the MSH classification for hemiplegic patients, which is based on the clinical deficits seen after the stroke, and to distinguish between the M group (motor deficit), MS group (motor and sensory deficits) and the MSH group (motor, sensory and homonymous deficits).

A prospective analytical study was made of the hemiplegic patients admitted consecutively to the Rehabilitation Department after strokes. The initial examination was made 17 days (CI: 15-19) after the stroke. Satisfactory functional results were considered to be obtaining a Barthel index of > 90 together with the ability to walk unaided on level ground six months after the stroke.

Of the 55 patients finally included in the study, 23 were in group M (41.8%) 21 in group MS (38.1%) and 11 patients in group MSH (20.1%). Walking ability and function in the different cohorts showed a statistically significant difference. Whilst 96% of the patients with pure hemiparesia (group M) attained a satisfactory degree of independence in walking, only 54% of the patients with three associated deficits (MSH) achieved this. Even more difference was found with acquired functional independence, since whilst 82% of group M attained a good degree of autonomy in carrying out everyday activities, only 18% of the MSH group achieved this. The remaining patients (MS group) had intermediate results.

The MSH classification is, soon after having a stroke, a useful means of determining the functional prognosis of hemiplegic patients.