I hvilken grad kan en modifisert prediksjonsalgoritme utført ved innkomst predikere armfunksjon ved utskrivelse og etter 3 måneder hos subakutte slagpasienter i en rehabiliteringsavdeling i Norge.

Abstract

Background: Stroke patients often ask physiotherapists if they will be able to use their affected upper limb again. The Predict REcovery Potential (PREP2) algorithm is a prediction tool which can be modified to local conditions to help provide an answer to this question. Objective: To investigate the accuracy of a modified mPREP2 at discharge and 3 months follow-up in subacute stroke patients in a rehabilitation unit in Norway and whether cognitive impairment, sensory loss and shoulder pain affected the predictions. Methods: This pragmatic trial consecutively studied patients  18 years with a goal to improve upper limb function after stroke. Within a month post stroke, patients were assessed with age, upper limb muscle strength and stroke severity by applying a modified PREP2 algorithm to establish a baseline prediction. The action reach arm test (ARAT) was used to evaluate the accuracy of the baseline predictions at discharge and at 3 months follow up. Methods of analysis were descriptive statistics and Chi square of Independence using Fishers Exact Probability Test. Results: 21 patients were included. 62% achieved predicted outcome category at discharge and 43% at 3 months follow up. An association between upper limb muscle strength and achieving a correct prediction was not found. Neglect and severe sensory loss were associated with “limited” and “poor” outcome categories. Shoulder pain was not associated with specific outcome categories. Conclusion: Patients achieving or achieved better than predicted outcome categories “excellent” and “good” were not associated with severe sensory loss and/or neglect.