Correlation of Radio-anatomic Site of Stroke with Motor Recovery and Functional Outcome in Ischemic Stroke Patients: A Hospital-based Prospective Cohort Study
Kaustav B Thakur, N Romi Singh, Jotin S Yengkhom, Utpalendu Debnath, Lisham R Singh
Ischemic stroke, Motor recovery, National Institutes of Health stroke scale, Stroke rehabilitation,Functional outcome
Citation Information :
Thakur KB, Romi Singh N, Yengkhom JS, Debnath U, Singh LR. Correlation of Radio-anatomic Site of Stroke with Motor Recovery and Functional Outcome in Ischemic Stroke Patients: A Hospital-based Prospective Cohort Study. Indian J Phy Med Rehab 2017; 28 (4):115-121.
Introduction: Stroke is a global health problem and a leading cause of morbidity and mortality. The site of lesion in stroke is determined with either non contrast computed tomography or Magnetic resonance imaging (MRI) scan of brain. Clinical evidence suggests that the site of damage influences the pattern of motor deficits. Thus, motor recovery and functional outcome after stroke may vary according to the location and size of brain lesions. The relationship between the location of brain lesions and motor and functional outcomes in stroke patients still remains controversial. The present study was performed to find out such association, if any.
Materials and methods: A prospective cohort study was conducted in the department of physical medicine and rehabilitation (PMR), regional institute of medical sciences (RIMS) with 60 patients fulfilling the inclusion and exclusion criteria attending between September 2015 and August 2017. Valid informed consent from patients and ethical approval were taken. The outcome measures used were Functional Independence Measure (FIM) and Brunnstrom stages of recovery. Stroke severity was assessed by National Institutes of Health (NIH) Stroke Scale. Follow-up assessment was done at 3rd and 6th month post stroke. Data were entered and analyzed in SPSS version 21. A two-way mixed analysis of variance (ANOVA) was done to find out the effect of location of lesion on motor recovery and functional outcome; p-value < 0.05 was taken as statistically significant.
Results: A total of 60 patients were included in our study with a mean age of 58.47 ± 7.67 years. Male constituted 56.7% and female 43.3% in our study. Maximum patients were in the age group of 61 to 65 years (53.3%). Subcortical stroke was found to be the most common site of lesion (56.7%). Computed tomography (CT) scan was positive for ischemic features in 44 patients (73.33%). The rest of the 16 patients (26.67%) either showed normal study or location not correlating with the clinical features the patients presented with. Magnetic resonance imaging was advised for these patients and showed positive ischemic features confirming stroke or affecting other anatomical sites. Stroke in basal ganglia showed a statistically significant improvement in motor recovery (p = 0.0008) and functional outcome (p = 0.047). Similarly, minor stroke had the best motor recovery and functional outcome (p < 0.001).
Conclusion: The present study showed the relationship of radio-anatomic site of stroke with motor recovery and functional outcome. It also found that stroke in basal ganglia had a statistically significant improvement in motor recovery and functional outcome.
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