Temporal recovery and predictors of upper limb dexterity in the first year of stroke: a prospective study of patients admitted to a rehabilitation centre.

Objective: To document temporal recovery of upper extremity dexterity and establish predictors of limb dexterity in a cohort of stroke patients in the first year after stroke.

Design: Prospective cohort study.

Subjects: One hundred patients with a first-ever ischemic stroke admitted to a rehabilitation centre.

Methods: Assessment of upper extremity dexterity, motor power and selfcare function using the Motor Assessment Scale (MAS), Upper Extremity Motor Index (UEMI) and Modified Barthel Index (MBI) respectively.

Results: Eighteen percent, 25.5% and 31.6% of patients recovered limb dexterity at 3, 6 and 12 months after stroke respectively. Patients who recovered dexterity late (≥6 months after stroke) were significantly younger with lower rehabilitation admission UEMI scores than those who recovered dexterity early. The UEMI score was the most significant correlate of limb dexterity at all follow up periods. Recovery of limb dexterity at 12 months was predicted by UEMI (OR1.54, 95% CI 1.13-2.10) and MBI (OR 1.03, 95% CI 1.00-1.07) scores on admission to rehabilitation.

Conclusions: In this study, 31.6% of patients recovered upper extremity dexterity at 12 months after stroke. Although late recovery of dexterity occurs only in a small proportion of patients, this finding is still pertinent given the significant impact of dexterity on upper limb and selfcare function.