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Marie-Claire Smith1, Suzanne J Ackerley1, P Alan Barber1,2

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The PREP2 algorithm accurately predicts upper-limb motor recovery 2 years after stroke. This stroke recovery prediction tool remained valid in a long-term follow-up study.

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Area of Science:

  • Neuroscience
  • Rehabilitation Medicine
  • Clinical Neurology

Background:

  • The PREP2 algorithm uses clinical and neurophysiological data to predict upper-limb (UL) motor outcomes at 3 months poststroke.
  • Previous validation showed the algorithm's accuracy for 75% of participants at 3 months.

Purpose of the Study:

  • To assess the long-term accuracy of PREP2 predictions at 2 years poststroke.
  • To evaluate the stability of upper-limb motor function between 3 months and 2 years poststroke.

Main Methods:

  • Follow-up study of 192 participants from the original PREP2 validation cohort.
  • 157 participants with 3-month poststroke assessments were invited for 2-year follow-up.
  • Upper-limb outcomes assessed using the Action Research Arm Test (ARAT), Fugl-Meyer Scale, and Motor Activity Log.

Main Results:

  • PREP2 predictions were correct for 80% (69/86) of participants at 2 years poststroke.
  • Upper-limb outcome categories remained stable between 3 months and 2 years for 83% (71/86) of participants.
  • No significant differences in baseline characteristics were found between patients with stable, improved, or deteriorated outcomes.

Conclusions:

  • PREP2 algorithm predictions made early poststroke are accurate for most patients at both 3 months and 2 years.
  • The algorithm demonstrates sustained predictive validity for long-term upper-limb motor outcomes.
  • Further research is needed to identify predictors of functional change between 3 months and 2 years poststroke.