Predicting arm recovery following stroke: value of site of lesion

Objectives - The aims of this study were to assess whether the site of lesi on is predictive of upper limb recovery after stroke and to determine wheth er this information adds to the predictive ability of the clinical examinat ion. Material and methods - Forty-five patients were examined at entry to t he study and at 2 and 12 months after stroke. The Brunnstrom-Fugl-Meyer tes t was used as outcome measurement. Predictor variables included clinical pa rameters and classifications of lesion site (obtained by CT/MRI). Results - Correlation analysis revealed small to moderate relationships between lesi ons of subcortical structures and arm outcome at 2 months. In multiple regr ession analysis, the best model for predicting recovery at 2 months was fou nd to be a combination of the clinical parameters with a purely subcortical lesion. Motor recovery at 12 months was best predicted by the clinical tes ts alone. The results further indicated that patients with subcortical dama ge tended to take longer to recover. Conclusions - Clinical assessment is m ost useful for determination of the prognosis of upper limb recovery after stroke. Neuroanatomical parameters measured by CT or MRT can only act as an adjunct.