Session Time: 12:30pm-2:00pm
Location: Research Hub - Kiosk 6
Disclosures: Laura Malmut, MD: Nothing to disclose
Objective: To determine if assessing shoulder abduction, elbow flexion and pinch grip using the arm-subscore of the Motricity Index (AMI) 1 week following ischemic stroke can be used to predict capacity for functional arm and hand use at 1- and 3-months follow-up using the Action Research Arm Test (ARAT).
Design: Prospective cohort study.
Setting: A single acute care hospital and affiliated acute inpatient rehabilitation institution.
Participants: Ninety-five patients (48 women, 47 men) with acute ischemic stroke.
Interventions: Conventional therapy.
Main Outcome Measures: Arm and hand dexterity of the impaired limb was assessed using AMI and ARAT at 1 week, 1 month, and 3 months following stroke onset. Good capacity for upper extremity function was defined as ARAT>45.
Results: Mean age was 68 years. Patients were evaluated at mean±SD 7.51±4.73, 33.88±41.33, and 113.68±53.59 days following stroke. Mean±SD AMI at 1 week was 61.94±37.84. Mean±SD ARAT scores at 1 week, 1 month, and 3 months were 26.37±23.22, 29.27±22.56 and 40.66±21.30, respectively. A 5-point increase in AMI was associated with good capacity for upper extremity function at 1 month (odds ratio, OR=1.56, 95%CI: 1.23-2.39, P=.008) and at 3 months (OR=1.26, 95%CI: 1.12-1.48, P<.001), adjusted for days since stroke. Receiver operating characteristic curve-based AMI cut-offs for classifying good capacity for upper extremity function at 1 month and 3 months were 80.5 (93.75% specificity; 75% sensitivity) and 58 (84.62% specificity; 87.50% sensitivity).
Conclusions: Clinicians are expected early in a patient’s rehabilitation course to predict functional recovery and formulate a realistic prognosis for patients with stroke. AMI is a measure of motor impairment that provides information about limb function and can be easily incorporated into a routine bedside examination. This study shows that early AMI at 1 week can be used to predict arm and hand dexterity as measured by ARAT at 1 month and 3 months post-stroke. Accurate prediction of upper limb function following stroke can support realistic discharge planning, goal setting, and set reasonable expectations for recovery.
Level of Evidence: Level I
To cite this abstract in AMA style:Malmut L, Lin C, Srdanovic N, Kocherginsky M, Harvey R, Prabhakaran S. Predicting Recovery of Upper Extremity Dexterity Using Motricity Index in Acute Ischemic Stroke [abstract]. PM R. 2019; 11(S2)(suppl 2). https://pmrjabstracts.org/abstract/predicting-recovery-of-upper-extremity-dexterity-using-motricity-index-in-acute-ischemic-stroke/. Accessed December 3, 2023.
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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/predicting-recovery-of-upper-extremity-dexterity-using-motricity-index-in-acute-ischemic-stroke/