Functional Prognosis Post Stroke : a Longitudinal Study

The main purpose of this project is to follow up the long-term recovery course of stroke patients for three years at the body, person, and social levels. Although the recovery course of stroke is studied more frequently than other types of neurological impairments, most of such information is based on western populations and reported in western literature. We still lack the data on stroke recovery in Taiwan. Stroke is a major cause for physical and mental disabilities in the old age populations in Taiwan. Given the fact that aged population in Taiwan is growing rapidly, it is urgent to systematically follow up the long-term recovery course of stroke patients for establishing the database in Taiwan. Specific aims of this project are five-fold: (1) to determine the recovery course of stroke patients on clinical and biomechanical measures (e.g., kinematic measures) at multiple dimensions; (2) to study the time course of recovery related to initial stroke severity; (3) to understand how the kinematic data on both upper arms afford additional insights into functional prognosis above and beyond the clinical scales; (4) to investigate the recovery course of the ipsilesional limb manifested by neurological and kinematic measures; and (5) to examine the impact of time course of recovery on the responsiveness of both upper extremities to environmental changes. This is a cohort study consecutively following patients with a first stroke admitted to Department of Physical Medicine and Rehabilitation at Chang Gung Memorial hospital between 1/2002 and 12/2003. The outcome measures include clinical and kinematic measures. The clinical measures involve the neurological scales such as the National Institute Health Stroke Scale and the Fugl-Meyer measure at the body level. They also involve the Functional Independence Measure at the person level to assess the dimension of self-care and the Sort Form-26 at the social level to evaluate quality of life. In addition, the contralesional and ipsilesional arm movements will be recorded kinematically under different environmental conditions to observe the detailed changes of performance and the responsiveness to environmental changes during the time course of recovery. The environmental changes will involve the conditions of the presence of object placed in the contralesional, midline, and ipsilesional positions and the conditions of object absent where participants will reach toward the described three locations. The results will assist in prognostication in the early phase of stroke, rational planning of rehabilitation, informing patients and family about the possibility of further recovery, and rationaling the health care policy.

Project ID:PG9104-0013
External Project ID:NHRI-EX91-9103EC