Ipsilesional Handgrip Strength and Functional Outcomes After Stroke: A Retrospective Cohort Study

Background and Objectives: Handgrip strength of the ipsilesional hand is increasingly recognized as a prognostic marker in stroke rehabilitation. Therefore, this retrospective observational cohort study investigated the association between baseline ipsilesional handgrip strength and functional outcomes after subacute stroke, while additionally incorporating age- and sex-adjusted normative handgrip strength thresholds, sex-stratified analyses, and exploratory regression models. Materials and Methods: This study was conducted on 180 ischaemic stroke patients admitted to the Neurorehabilitation Unit between 2020 and 2024. Handgrip strength of both hands was measured at admission and discharge. Functional status was assessed using standardized assessments: the Functional Independence Measure (FIM) and the Barthel Index (BI). Correlation analyses were performed to evaluate associations between handgrip strength and functional outcomes. Results: Among 180 participants, those with age- and sex-adjusted normative ipsilesional handgrip strength demonstrated significantly higher FIM scores both before and after rehabilitation (p = 0.008 and p = 0.042), whereas no significant differences were found for the remaining functional outcome measures. In sex-stratified regression analyses, baseline handgrip strength of the ipsilesional hand was significantly associated with FIM score at discharge in both male (B = 0.705, 95% CI: 0.312 to 1.099, p < 0.001) and female participants (B = 0.735, 95% CI: 0.076 to 1.394, p = 0.029). Conclusions: The results of this study confirmed that handgrip strength of the ipsilesional hand is significantly associated with functional outcomes at the end of inpatient stroke rehabilitation. These findings support its potential value as a simple clinical indicator of functional recovery, although the proposed regression models require external validation before clinical application.