Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2020 Nov 17:2020:8216758.
doi: 10.1155/2020/8216758. eCollection 2020.

Milestones and Timescale of Poststroke Recovery: A Cohort Study

Marianna Loi  1 , Alberto Zaliani  1 , Marta Abbamonte  2 , Elena P Ferrari  3 , Roberto Maestri  4 , Luigi Trojano  5 , Pietro Balbi  6
Affiliations
Observational Study

Milestones and Timescale of Poststroke Recovery: A Cohort Study

Marianna Loi et al. Behav Neurol. .

Abstract

Background: Progressive increase of an aging population in Western countries will result in a growth of stroke prevalence. As many stroke survivors chronically show severe disability, increase in economic, social, and medical burden could be expected in the future. Objective and subjective measures of poststroke recovery are necessary to obtain predictive information, to improve the treatments, and to better allocate resources.

Aim: To explore a measure of the temporal dimension of poststroke recovery, to search for predictive association with multiple clinical variables, and to improve tailoring of poststroke treatments.

Method: In this observational monocentric cohort study, 176 poststroke inpatients at their first cerebrovascular event were consecutively enrolled. A novel measure based on the time needed to reach the main milestones of motor recovery was proposed. Moreover, two commonly used outcome measures, a measure of global functioning (Functional Independence Measure (FIM™)) and a measure of neurological poststroke deficit (Fugl-Meyer scale), were collected for the investigations of possible predictors.

Results: The patients showed a substantial increase in Fugl-Meyer and FIM scores during the rehabilitative treatment. The acquisition of three milestones was significantly associated with female sex (autonomous standing), length of stay and Fugl-Meyer initial score (autonomous walking), and Fugl-Meyer initial score (functional arm). These findings provided quantitative data on motor milestone reacquisition in a sample of poststroke patients. It also demonstrated the value of the Fugl-Meyer score in predicting the acquisition of two motor milestones, relevant for daily life activities.

Conclusion: Systematic recording of the timescale of poststroke recovery showed that motor milestone reacquisition happens, on average and when attainable, in less than 30 days in our sample of patients. The present study underscores the importance of the Fugl-Meyer score as a possible predictor for better improvement in reacquisition times of milestone functional recovery.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any financial or nonfinancial relationships that could be construed as a potential conflict of interest. The present research was performed as part of the activities of the authors as employees of “Istituti Clinici Scientifici Maugeri IRCCS”.

Figures

Figure 1
Figure 1
Flow diagram.
Figure 2
Figure 2
(a) Cumulative frequencies of autonomous standing acquisition times; abscissa, times of milestone acquisition; ordinate, absolute number of patients. (b) Single frequencies of milestone acquisition, ordered according to their frequency; columns, absolute number of patients; line, cumulative percentage.
Figure 3
Figure 3
(a) Cumulative frequencies of autonomous walking acquisition times; abscissa, times of milestone acquisition; ordinate, absolute number of patients. (b) Single frequencies of milestone acquisition, ordered according to their frequency; columns, absolute number of patients; line, cumulative percentage.
Figure 4
Figure 4
(a) Cumulative frequencies of functional arm acquisition times; abscissa, times of milestone acquisition; ordinate, absolute number of patients. (b) Single frequencies of milestone acquisition, ordered according to their frequency; columns, absolute number of patients; line, cumulative percentage.
See this image and copyright information in PMC

References

    1. Feigin V. L., Abajobir A. A., Abate K. H., et al. Global, regional, and national burden of neurological disorders during 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015. The Lancet Neurology. 2017;16(11):877–897. doi: 10.1016/S1474-4422(17)30299-5. - DOI - PMC - PubMed
    1. Graham L. A. Organization of rehabilitation services. In: Barnes M. P., Good D. C., editors. Handbook of Clinical Neurology, Neurologic Rehabilitation. Vol. 110. Amsterdam: Elsevier; 2013. pp. 113–120. - PubMed
    1. Musicco M., Emberti L., Nappi G., Caltagirone C., for the Italian Multicenter Study on Outcomes of Rehabilitation of Neurological Patients Early and long-term outcome of rehabilitation in stroke patients: the role of patient characteristics, time of initiation, and duration of interventions. Archives of Physical Medicine and Rehabilitation. 2003;84(4):551–558. doi: 10.1053/apmr.2003.50084. - DOI - PubMed
    1. Ganguly K., By N. N., Abrams G. M. Neurorehabilitation: motor recovery after stroke as an example. Annals of Neurology. 2013;74(3):373–381. doi: 10.1002/ana.23994. - DOI - PubMed
    1. Scrutinio D., Monitillo V., Guida P., et al. Functional gain after inpatient stroke rehabilitation. Stroke. 2015;46(10):2976–2980. doi: 10.1161/STROKEAHA.115.010440. - DOI - PubMed

Publication types