Predicting recovery of dextrous hand function in acute stroke

Area of Science:

• Neurology
• Rehabilitation Medicine
• Clinical Neuroscience

Background:

• Stroke frequently causes upper extremity (UE) paresis, impacting hand dexterity and functional recovery.
• Predicting long-term hand function is crucial for tailoring rehabilitation strategies post-stroke.

Purpose of the Study:

• To identify early clinical predictors of dextrous hand function at 6 months post-stroke.
• To evaluate the predictive value of various clinical characteristics during acute stroke.

Main Methods:

• Fifty-seven acute stroke patients were assessed for hand function recovery using the Action Research Arm Test.
• Evaluated predictors included infarct location, stroke severity, cognition, spatial neglect, two-point discrimination (2-PD), muscle tone, and UE muscle strength.
• Assessments were conducted weekly for the first 4 weeks, then monthly up to 6 months post-stroke.

Main Results:

• Infarct site, stroke severity, 2-PD, and UE muscle strength were independently associated with 6-month hand function.
• Early predictors (weeks 1-3) included 2-PD (OR 0.51-0.83).
• UE muscle strength (OR ≥ 1.04) predicted function in the first 2 months, with strength at week 4 being the strongest single predictor.

Conclusions:

• Muscle strength and 2-PD in the paretic UE within the first month post-stroke are key predictors of 6-month dextrous hand function recovery.
• These findings aid in early prognostication and personalized rehabilitation planning.