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Motor function recovery in patients with ischemic versus hemorrhagic stroke during the first year

Conference contribution
Authors Hanna C Persson
Arve Opheim
Åsa Lundgren Nilsson
Margit Alt Murphy
Anna Danielsson
Katharina S Sunnerhagen
Published in Nordic Stroke 2015. 18th Nordic Congress on Cerebrovascular Diseases. 26-28 August 2015, Malmö, Sweden
Publication year 2015
Published at Institute of Neuroscience and Physiology, Department of Clinical Neuroscience and Rehabilitation
Language en
Keywords stroke, upper extremity, recovery of function, longitudinal studies
Subject categories Neuroscience, Physiotherapy


Background and purpose Few studies have investigated the recovery of motor function in the upper extremity according to the sub types ischemic and hemorrhagic stroke. Different recovery patterns in upper extremity motor function have clinically been described, but there is a lack of research. The purpose of the present study was to investigate possible differences in the recovery of upper extremity motor function in patients with ischemic versus intracerebral hemorrhagic stroke during the first year after a stroke. Materials and methods Patients with a first ever stroke and impaired upper extremity function 3 days after onset were consecutively included in the Stroke Arm Longitudinal Study at the Gothenburg University study during 2009-2011. Upper extremity function was investigated with the Fugl-Meyer Assessment for Upper Extremity (FMA-UE) at 3 and 10 days and at 1, 3, 6 and 12 months, age and initial stroke severity were assessed day 1. To compare changes over time in ischemic and hemorrhagic stroke, the Mixed model repeated measurement was used. A p-value <0.05 at was considered statistically significant. Results Of 117 patients, 98 had ischemic (mean 70 years), and 19 had hemorrhagic stroke (mean 62 years). A wide spread in upper extremity motor function recovery was seen. Statistically significant differences over the first year between ischemic and hemorrhagic stroke (interaction of type of stroke and time since onset, p= 0.001 at 3, 10 days and 1 month) were seen, where patients with ischemic stroke started at a higher FMA-UE level but at 3 months the two groups had approximately same level of motor function. Initial stroke severity and age had a significant impact on the recovery pattern. Conclusion Patients with ischemic stroke has during the first 3 months higher motor function and recover faster compared to hemorrhagic stroke. Thereafter no significant difference was seen. The type of stroke (ischemic or hemorrhagic) is of most relevance for the recovery process in the sub-acute phase, but still, the wide-ranging individual changes emphasizes the importance of individually based rehabilitation. Further studied are needed to confirm these results.

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