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Updated: Nov 29, 2025

Determining the Functional Status of the Corticospinal Tract Within One Week of Stroke
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Accuracy of the Upper Limb Prediction Algorithm PREP2 Applied 2 Weeks Poststroke: A Prospective Longitudinal Study.

Camilla Biering Lundquist1, Jørgen Feldbæk Nielsen1, Federico Gabriel Arguissain1,2

  • 1Hammel Neurorehabilitation Centre and University Research Clinic, Hammel, Denmark.

Neurorehabilitation and Neural Repair
|November 21, 2020
PubMed
Summary

The Predict Recovery Potential algorithm (PREP2) showed low accuracy (60% correct classification) for predicting upper limb function in subacute stroke patients. Its clinical use is limited, though it may identify patients with excellent or poor recovery.

Keywords:
PREP2algorithmspredictionrehabilitationstrokeupper extremity

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Area of Science:

  • Neuroscience
  • Rehabilitation Medicine
  • Clinical Prediction Models

Background:

  • The Predict Recovery Potential algorithm (PREP2) aids early stroke upper limb (UL) function prediction.
  • Acute phase assessment for PREP2 is not always feasible.

Purpose of the Study:

  • To evaluate PREP2's prognostic accuracy in a subacute neurorehabilitation setting.
  • To compare PREP2 predictions with actual UL function outcomes at 3 months post-stroke.

Main Methods:

  • Prospective longitudinal study of 91 stroke patients (≥18 years) with UL impairment.
  • PREP2 components (SAFE score, MEPs) assessed 2 weeks post-stroke.
  • UL function predicted into 4 categories; outcomes measured by Action Research Arm Test at 3 months.

Main Results:

  • Overall correct classification rate (CCR) for PREP2 was 60% (95% CI 50%-71%).
  • CCR varied by category, from 33% (Limited) to 78% (Poor).
  • This study's CCR was significantly lower than the 75% reported by PREP2 developers (P < .001).

Conclusions:

  • PREP2, when applied 2 weeks post-stroke, has insufficient accuracy for routine clinical use.
  • PREP2 may still assist in identifying patients with potential for excellent recovery or persistent severe UL deficits.