Motor and Dexterity Assessments as Predictors of Functional Independence in Post-stroke Patients

Stroke is a leading cause of long-term disability, and early functional prognostication is essential for individualized rehabilitation planning.

The objective of the study is to examine the association between bedside motor and dexterity tests and standard outcome measures, and to evaluate their predictive value for functional independence in post-stroke patients.

This observational study was conducted at the Neurology Clinic, University Clinical Center Sarajevo, Sarajevo, Bosnia and Herzegovina, and included 61 patients with either ischemic or hemorrhagic stroke. Sociodemographic and clinical data were collected. Bedside functional assessments comprised the National Institutes of Health Stroke Scale (NIHSS), the Motor Assessment Scale (MAS), the Nine-Hole Peg Test (9-HPT) for upper limb dexterity, and the Berg Balance Scale (BBS). Functional outcomes were evaluated using the Barthel Index and the modified Rankin Scale (mRS) at admission and discharge. Associations between bedside assessments and functional outcomes were analyzed using correlation analyses, and independent predictors of functional independence were identified using multivariable linear regression models.

The mean age of participants was 74.8 ± 5.5 years, and 73.8% had ischemic stroke. Functional independence improved during hospitalization, with the Barthel Index increasing from 65.3 ± 22.9 at admission to 72.1 ± 26.5 at discharge. In multivariable regression analysis, the MAS emerged as the strongest independent predictor of functional independence measured by the Barthel Index (R² = 0.88, β = 1.49; p < 0.001). Performance on the 9-HPT using the non-dominant hand provided additional independent predictive value (β = -0.28; p = 0.048), while dominant-hand dexterity and balance performance were not significant predictors in the adjusted model.

Simple bedside motor and dexterity assessments provide clinically relevant prognostic information in the early post-stroke phase. Their integration into routine clinical practice may enhance functional prognostication and support individualized rehabilitation strategies.