London, United Kingdom 2013 Poster Session Red Cerebrovasc Dis 2013; 35 (suppl 3)1-854 335 104 Stroke prognosis Prediction of upper limb recovery, general disability and rehabilitation status by activity mea-surements assessed by accelerometeters or the Fugl-Meyer score in acute stroke N. Gebruers1, S. Truijen2, S. Engelborghs3, P.P. De Deyn4 Artesis University College of Antwerp, Antwerp, BELGIUM1, Artesis University College of An-twerp, Antwerp, BELGIUM2, University of Antwerp, Antwerp, BELGIUM3, University of Antwerp, Antwerp, BELGIUM4 Background: Accelerometry is easily applicable without the cooperation of the patient which makes it a probable useful tool in acute stroke. This study investigated the clinical predictive value of the Fugl-Meyer arm score (FMA) and the upper limb activity assessed by acceleromters in patients with a motor hemisyndrome after acute stroke. The activity variables (activity of the impaired arm and RATIO) as well as the FMA score were related to the modified Rankin Scale (mRS), FMA score and rehabilitation (RS) status 3 months after stroke. Methods: 129 patients (table 1) with acute stroke were included after written consent. All patients wore 2 octagonal basic motion loggers for 48h, one at each wrist. The activity variables and FMA score at intake were related to FMA, mRS, and reha-bilitation status (RS) after 3 months of follow-up. The prediction model was based upon a binary lo-gistic regression since all outcome measures were dichotomised ( cut off values: FMA <45/66; mRS ≤2/5 and RS 0 = home and 1= rehabilitation centre or retirement home) Results: Although the FMA score at intake has the best overall predictive value for all three outcome measures (FMA3 = 87.6%; mRS = 85.3%; RS = 73.6%), the activity of the impaired arm has the best predictive value to deter-mine patients who are at risk for continued disability (mRS score 1= 95.1%). The results demon-strate that the most difficult outcome measure for prediction is the rehabilitation status; specifically the patients that went home are predicted imprecise. The ratio variable is the least accurate predictor of all tested variables (table 2). Conclusions: The Fugl-Meyer arm score at intake is the best predic-tor for arm recovery as well as general disability. The activity of the impaired arm is an excellent in-dicator for prolonged disability and is an alternative to the FMA score when it is impossible to score the FMA in the acute phase of stroke. Table 1: Demographic characteristics of the study participants Variable Patients with acute stroke (n = 129) Age (y) Mean (SD) 74.0 (11.4) Height (m) Mean (SD) 1.69* (.09) Weight (kg) Mean (SD) 76.6* (15.2) BMI Mean (SD) 26.6* (4.2) Gender: Male n (%) Female n (%) 51 (39.5) 78 (60.5) Type of stroke: Ischemic n (%) Haemorrhage n (%) 117 (91) 12 (9) Side of paresis: Right n (%) Left n (%) 65 (50%) 64 (50%) Side affected: Dominant n (%) Non-dominant n (%) 59 (46) 70 (54) NIHSS( median IQR) 9 9 FMA (median IQR) 21 48 Activity impaired arm (mean/ SD) counts° 870718 638490 Activity non-impaired arm (mean/SD) 1874887 882943 Ratio (mean/SD) .57 .71 * n = 121 ° activity is presented as the total counts over 1 day (24h) Table 2: Prediction values Percent-age % Prediction of the outcome measure FMA at 3 months* mRS at 3 months° Rehabilitation sta-tus ˆ Pre-diction variable at intake 0 1 Over-all 0 1 Over-all 0 1 Over-all FMA 88.5 87.3 87.6 82.4 86.9 85.3 65.9 78.8 73.6 Activ-ity im-paired 65.4 88.9 82.0 67.6 95.1 85.3 43.0 86.4 69.0 arm Ratio 69.2 85.7 80.9 64.7 88.5 80.0 24.4 85.7 61.5 * n=89 ° n=117 ^ n=104 FMA 0 = <45/66 FMA 1 = 45 or more mRS 0 = <3/5 mRS 1 = 3 or more RS 0 = home RS 1= rehabilitation centre or retirement home Ratio = activity of the impaired arm divided by the activity of the non-impaired arm
Karger_ESC London_2013
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