Impact of Post-Stroke Recanalization on General and Upper Limb Functioning: A Prospective, Observational Study

• Published in: Neurology international Vol. 13; no. 1; pp. 46 - 58
• Main Authors: Branco, João Paulo, Rocha, Filipa, Sargento-Freitas, João, Santo, Gustavo C., Freire, António, Laíns, Jorge, Páscoa Pinheiro, João
• Format: Journal Article
• Language: English
• Published: Italy MDPI AG 04.02.2021; MDPI
• Subjects: Cardiac arrhythmia; Clinical medicine; functionality; functioning; Hypertension; Observational studies; Occupational therapy; Patients; recanalization; Rehabilitation; Stroke; upper limb; Portugal; upper limb; functioning; rehabilitation; recanalization; functionality; stroke
• ISSN: 2035-8377; 2035-8385; 2035-8377
• DOI: 10.3390/neurolint13010005

The objective of this study is to assess the impact of recanalization (spontaneous and therapeutic) on upper limb functioning and general patient functioning after stroke. This is a prospective, observational study of patients hospitalized due to acute ischemic stroke in the territory of the middle cerebral artery (n = 98). Patients completed a comprehensive rehabilitation program and were followed-up for 24 weeks. The impact of recanalization on patient functioning was evaluated using the modified Rankin Scale (mRS) and Stroke Upper Limb Capacity Scale (SULCS). General and upper limb functioning improved markedly in the first three weeks after stroke. Age, gender, and National Institutes of Health Stroke Scale (NIHSS) score at admission were associated with general and upper limb functioning at 12 weeks. Successful recanalization was associated with better functioning. Among patients who underwent therapeutic recanalization, NIHSS scores ≥16.5 indicate lower general functioning at 12 weeks (sensibility = 72.4%; specificity = 78.6%) and NIHSS scores ≥13.5 indicate no hand functioning at 12 weeks (sensibility = 83.8%; specificity = 76.5%). Recanalization, either spontaneous or therapeutic, has a positive impact on patient functioning after acute ischemic stroke. Functional recovery occurs mostly within the first 12 weeks after stroke, with greater functional gains among patients with successful recanalization. Higher NIHSS scores at admission are associated with worse functional recovery.