Long-term recovery of upper limb motor function and self-reported health: results from a multicenter observational study 1 year after discharge from rehabilitation.
Neurological rehabilitation
Patient outcome assessment
Recovery of function
Stroke
Upper extremity
Journal
Neurological research and practice
ISSN: 2524-3489
Titre abrégé: Neurol Res Pract
Pays: England
ID NLM: 101767802
Informations de publication
Date de publication:
27 Dec 2021
27 Dec 2021
Historique:
received:
20
08
2021
accepted:
05
11
2021
entrez:
27
12
2021
pubmed:
28
12
2021
medline:
28
12
2021
Statut:
epublish
Résumé
Impaired motor functions after stroke are common and negatively affect patients' activities of daily living and quality of life. In particular, hand motor function is essential for daily activities, but often returns slowly and incompletely after stroke. However, few data are available on the long-term dynamics of motor recovery and self-reported health status after stroke. The Interdisciplinary Platform for Rehabilitation Research and Innovative Care of Stroke Patients (IMPROVE) project aims to address this knowledge gap by studying the clinical course of recovery after inpatient rehabilitation. In this prospective observational longitudinal multicenter study, patients were included towards the end of inpatient rehabilitation after ischemic or hemorrhagic stroke. Follow-up examination was performed at three, six, and twelve months after enrollment. Motor function was assessed by the Upper Extremity Fugl-Meyer Assessment (FMA), grip and pinch strength, and the nine-hole peg test. In addition, Patient-Reported Outcomes Measurement Information System 10-Question Short Form (PROMIS-10) was included. Linear mixed effect models were fitted to analyze change over time. To study determinants of hand motor function, patients with impaired hand function at baseline were grouped into improvers and non-improvers according to hand motor function after twelve months. A total of 176 patients were included in the analysis. Improvement in all motor function scores and PROMIS-10 was shown up to 1 year after inpatient rehabilitation. FMA scores improved by an estimate of 5.0 (3.7-6.4) points per year. In addition, patient-reported outcome measures increased by 2.5 (1.4-3.6) and 2.4 (1.4-3.4) per year in the physical and mental domain of PROMIS-10. In the subgroup analysis non-improvers showed to be more often female (15% vs. 55%, p = 0.0155) and scored lower in the Montreal Cognitive Assessment (25 [23-27] vs. 22 [20.5-24], p = 0.0252). Continuous improvement in motor function and self-reported health status is observed up to 1 year after inpatient stroke rehabilitation. Demographic and clinical parameters associated with these improvements need further investigation. These results may contribute to the further development of the post-inpatient phase of stroke rehabilitation. The trial is registered at ClinicalTrials.gov (NCT04119479).
Sections du résumé
BACKGROUND
BACKGROUND
Impaired motor functions after stroke are common and negatively affect patients' activities of daily living and quality of life. In particular, hand motor function is essential for daily activities, but often returns slowly and incompletely after stroke. However, few data are available on the long-term dynamics of motor recovery and self-reported health status after stroke. The Interdisciplinary Platform for Rehabilitation Research and Innovative Care of Stroke Patients (IMPROVE) project aims to address this knowledge gap by studying the clinical course of recovery after inpatient rehabilitation.
METHODS
METHODS
In this prospective observational longitudinal multicenter study, patients were included towards the end of inpatient rehabilitation after ischemic or hemorrhagic stroke. Follow-up examination was performed at three, six, and twelve months after enrollment. Motor function was assessed by the Upper Extremity Fugl-Meyer Assessment (FMA), grip and pinch strength, and the nine-hole peg test. In addition, Patient-Reported Outcomes Measurement Information System 10-Question Short Form (PROMIS-10) was included. Linear mixed effect models were fitted to analyze change over time. To study determinants of hand motor function, patients with impaired hand function at baseline were grouped into improvers and non-improvers according to hand motor function after twelve months.
RESULTS
RESULTS
A total of 176 patients were included in the analysis. Improvement in all motor function scores and PROMIS-10 was shown up to 1 year after inpatient rehabilitation. FMA scores improved by an estimate of 5.0 (3.7-6.4) points per year. In addition, patient-reported outcome measures increased by 2.5 (1.4-3.6) and 2.4 (1.4-3.4) per year in the physical and mental domain of PROMIS-10. In the subgroup analysis non-improvers showed to be more often female (15% vs. 55%, p = 0.0155) and scored lower in the Montreal Cognitive Assessment (25 [23-27] vs. 22 [20.5-24], p = 0.0252).
CONCLUSIONS
CONCLUSIONS
Continuous improvement in motor function and self-reported health status is observed up to 1 year after inpatient stroke rehabilitation. Demographic and clinical parameters associated with these improvements need further investigation. These results may contribute to the further development of the post-inpatient phase of stroke rehabilitation.
TRIAL REGISTRATION
BACKGROUND
The trial is registered at ClinicalTrials.gov (NCT04119479).
Identifiants
pubmed: 34955097
doi: 10.1186/s42466-021-00164-7
pii: 10.1186/s42466-021-00164-7
pmc: PMC8711154
doi:
Banques de données
ClinicalTrials.gov
['NCT04119479']
Types de publication
Journal Article
Langues
eng
Pagination
66Informations de copyright
© 2021. The Author(s).
Références
Clin Med (Lond). 2015 Oct;15(5):461-4
pubmed: 26430186
Lancet. 2011 May 14;377(9778):1693-702
pubmed: 21571152
Stroke. 2012 Jul;43(7):1982-7
pubmed: 22569940
Stroke. 2015 Jun;46(6):1613-9
pubmed: 25953370
Neurorehabil Neural Repair. 2008 Jan-Feb;22(1):64-71
pubmed: 17687024
Neurol Res Pract. 2020 Apr 6;2:10
pubmed: 33324916
Neurology. 2018 Nov 13;91(20):e1838-e1850
pubmed: 30333158
Neurorehabil Neural Repair. 2008 Mar-Apr;22(2):173-9
pubmed: 17876069
Arch Phys Med Rehabil. 2011 May;92(5):792-8
pubmed: 21530727
Lancet Neurol. 2009 Aug;8(8):741-54
pubmed: 19608100
Dtsch Arztebl Int. 2008 Jun;105(26):467-73
pubmed: 19626195
Womens Health (Lond). 2020 Jan-Dec;16:1745506520952039
pubmed: 32997605
Stroke. 2016 Jan;47(1):180-6
pubmed: 26604251
Neurology. 2019 Dec 10;93(24):e2170-e2180
pubmed: 31719135
Arch Phys Med Rehabil. 2014 Apr;95(4):595-6
pubmed: 24529594
Cerebrovasc Dis. 1999 May-Jun;9(3):163-70
pubmed: 10207209
Nervenarzt. 2020 Jun;91(6):477-483
pubmed: 32361775
Lancet Glob Health. 2013 Nov;1(5):e259-81
pubmed: 25104492
BMC Neurol. 2020 Oct 24;20(1):389
pubmed: 33099308
Top Stroke Rehabil. 2012 Nov-Dec;19(6):457-62
pubmed: 23192711
Restor Neurol Neurosci. 2004;22(3-5):281-99
pubmed: 15502272
Int J Stroke. 2017 Jul;12(5):444-450
pubmed: 28697708
Ann Neurol. 2015 Dec;78(6):845-7
pubmed: 26435166
Circulation. 2014 Jan 21;129(3):e28-e292
pubmed: 24352519
BMJ Open. 2013 Sep 03;3(9):e003105
pubmed: 24002980
PLoS One. 2017 Jun 14;12(6):e0179453
pubmed: 28614403
Gesundheitswesen. 2008 Mar;70(3):170-6
pubmed: 18415925
Int J Stroke. 2013 Jan;8(1):25-32
pubmed: 23280266
Scand J Rehabil Med. 1975;7(1):13-31
pubmed: 1135616
Int J Stroke. 2016 Jun;11(4):454-8
pubmed: 27073187
BMC Health Serv Res. 2018 Jun 19;18(1):468
pubmed: 29914476
Physiotherapy. 2020 Jun;107:216-223
pubmed: 32026823
Lancet. 2014 Jan 18;383(9913):245-54
pubmed: 24449944
Int J Neurosci. 2017 Jan;127(1):37-43
pubmed: 26759075
Dtsch Arztebl Int. 2011 Sep;108(36):600-6
pubmed: 21966318
BMC Neurol. 2019 Sep 7;19(1):221
pubmed: 31493791