Clinical characteristics and functional outcome after rehabilitation of middle cerebral artery stroke

ABSTRACT

To describe the clinical profile of MCA stroke. Also, to describe the functional outcome and to identify factors associated with functional changes after rehabilitation of MCA stroke. Sixty five hemiplegic patients due to MCA stroke were studied. Patients underwent complete neurological and functional evaluation on admission. Evaluation included stroke type, cardiovascular risk factors for stroke, associated neurological deficits, total motricity index [MI] of upper and lower extremities, motor function of the trunk assessed by Trunk Control Test [TCT], and Functional Independence Measure [FIM]. All patients were enrolled in an inpatient rehabilitation program. Patients were re-evaluated at discharge. Statistical analyses were carried out to determine factors associated with functional outcome after rehabilitation of MCA stroke. The total MI and TCT improved significantly after rehabilitation. In addition, discharge total FIM score was statistically higher than admission total FIM score. Patients with hemineglect, impaired cognition, dysphagia, hemihypoesthesia incontinence or multiple neurological deficits had significantly lower discharge total FIM score than patients without such variables. The discharge FIM score correlated strongly with admission total FIM score [r= 0.88, p<0.001] moderately with admission TCT score [r= 0.69, p<0.001], fairly with admission total MI [r=0.37, P=0.002] and negatively with age [r= -0.2, p=0.01]. On multiple linear regression analysis, admission total FiM and TCT scores score were the only significant predictors of discharge FIM scores. Rehabilitation improved the functional outcome of MCA stroke patients. The initial functional status was the most important factor associated with functional improvement