Improvement of Function and Motor Impairment After Stroke

Abstract

Improvement of function and motor impairment were studied prospectively in 75 consecutive hemiparetic stroke patients admitted to an in-patient stroke rehabilitation unit. Upper extremity (UE) function was assessed by the ability to feed and to dress the upper body. Lower extremity (LE) function was assessed by the ability to walk. The Brunnstrom Recovery Scale (BR, 1-6) on admission and on discharge was used to measure motor impairment. LE function improved in 83% and UE function improved in 52% of the patients. Improvement of UE and LE motor impairment occurred, however, in only 26% and 29%, respectively. No significant relationship between functional improvement and motor improvement could be demonstrated. UE motor impairment on admission related to improvement of UE function during rehabilitation. Of 23 patients with mild paresis on admission (BR scores < 5), 78% had improvement of UE function, whereas this was seen in only 37% of patients with lower admission BR scores and more severe paresis. LE motor impairment on admission was not related to improvement of LE function during rehabilitation. Improvement of function in patients with severe strokes (BR scores < 4) was more likely due to functional improvement of the nonparetic than of the paretic extremity. It is concluded that rehabilitation of stroke patients should be functionally oriented and be focused on the nonparetic as well as on the paretic extremities. © 1989, Sage Publications. All rights reserved.