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Published on: July 10, 2014
The crossed leg sign indicates a favorable outcome after severe stroke
J Rémi1, T Pfefferkorn, R L Owens
1Department of Neurology, University of Munich, Munich, Germany.
Insights
Leg crossing in severe stroke patients is a positive prognostic indicator. This simple clinical sign predicts better recovery, fewer neurological deficits, and reduced mortality rates.
Area of Science:
- Neurology
- Clinical Medicine
- Stroke Research
Background:
- Severe stroke poses significant challenges for patient recovery and long-term outcomes.
- Identifying early prognostic markers can aid in patient management and outcome prediction.
Purpose of the Study:
- To investigate if the act of crossing legs in patients with severe stroke serves as a prognostic marker for recovery.
- To determine if leg crossing correlates with neurological deficits, functional independence, and mortality.
Main Methods:
- A controlled prospective observational study comparing severe stroke patients who crossed their legs with matched controls who did not.
- Utilized scales such as the Glasgow Coma Scale (GCS), NIH Stroke Scale (NIHSS), modified Rankin Scale (mRS), and Barthel Index (BI) for evaluation.
- Evaluations were conducted at admission, during hospitalization, upon discharge, and at 1-year follow-up.
Main Results:
- Patients who crossed their legs showed significantly better outcomes at discharge and 1-year follow-up.
- Improved scores were observed in NIHSS, mRS, and BI for the leg-crossing group.
- Mortality rates were substantially lower in the leg-crossing group compared to controls (1 vs. 18 deaths).
Conclusions:
- Leg crossing is a simple, easily obtainable clinical sign indicating a favorable prognosis after severe stroke.
- This behavior predicts reduced neurological deficits, enhanced independence in daily life, and decreased mortality.
- Leg crossing is an independent prognostic marker, not requiring additional technical examinations.
Objective:
We investigated whether crossed legs are a prognostic marker in patients with severe stroke.
Methods:
In this controlled prospective observational study, we observed patients with severe stroke who crossed their legs during their hospital stay and matched them with randomly selected severe stroke patients who did not cross their legs. The patients were evaluated upon admission, on the day of leg crossing, upon discharge, and at 1 year after discharge. The Glasgow Coma Scale, the NIH Stroke Scale (NIHSS), the modified Rankin Scale (mRS), and the Barthel Index (BI) were obtained.
Results:
Patients who crossed their legs (n = 34) and matched controls (n = 34) did not differ in any scale upon admission. At the time of discharge, the GCS did not differ, but the NIHSS was better in crossed legs patients (6.5 vs 10.6; p = 0.0026), as was the mRS (3.4 vs 5.1, p < 0.001), and the BI (34.0 vs 21.1; p = 0.0073). At 1-year follow-up, mRS (2.9 vs 5.1, p < 0.001) and the BI (71.3 vs 49.2; p = 0.045) were also better in the crossed leg group. The mortality between the groups differed grossly; only 1 patient died in the crossing group compared to 18 in the noncrossing group (p < 0.001).
Conclusion:
Leg crossing is an easily obtained clinical sign and is independent of additional technical examinations. Leg crossing within the first 15 days after severe stroke indicates a favorable outcome which includes less neurologic deficits, better independence in daily life, and lower rates of death.
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