Inter-individual Variability in the Capacity for Motor Recovery After Ischemic Stroke.

Inter-individual Variability in the Capacity for Motor Recovery After Ischemic Stroke. Research Abstract Details 

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Inter-individual Variability in the Capacity for Motor Recovery After Ischemic Stroke. Abstract Text:

Shyam Prabhakaran,Eric Zarahn,Claire Riley,Allison Speizer,Ji Y Chong,Ronald M Lazar,Randolph S Marshall,John W Krakauer,Shyam Prabhakaran,Eric Zarahn,Claire Riley,Allison Speizer,Ji Y Chong,Ronald M Lazar,Randolph S Marshall,John W Krakauer,Shyam Prabhakaran,Eric Zarahn,Claire Riley,Allison Speizer,Ji Y Chong,Ronald M Lazar,Randolph S Marshall,John W Krakauer,

BACKGROUND: Motor recovery after stroke is predicted only moderately by clinical variables, implying that there is still a substantial amount of unexplained, biologically meaningful variability in recovery. Regression diagnostics can indicate whether this is associated simply with Gaussian error or instead with multiple subpopulations that vary in their relationships to the clinical variables. OBJECTIVE: To perform regression diagnostics on a linear model for recovery versus clinical predictors. METHODS: Forty-one patients with ischemic stroke were studied. Impairment was assessed using the upper extremity Fugl-Meyer Motor Score. Motor recovery was defined as the change in the upper extremity Fugl-Meyer Motor Score from 24 to 72 hours after stroke to 3 or 6 months later. The clinical predictors in the model were age, gender, infarct location (subcortical vs cortical), diffusion weighted imaging infarct volume, time to reassessment, and acute upper extremity Fugl-Meyer Motor Score. Regression diagnostics included a Kolmogorov-Smirnov test for Gaussian errors and a test for outliers using Studentized deleted residuals. RESULTS: In the random sample, clinical variables explained only 47% of the variance in recovery. Among the patients with the most severe initial impairment, there was a set of regression outliers who recovered very poorly. With the outliers removed, explained variance in recovery increased to 89%, and recovery was well approximated by a proportional relationship with initial impairment (recovery congruent with 0.70 x initial impairment). CONCLUSIONS: Clinical variables only moderately predict motor recovery. Regression diagnostics demonstrated the existence of a subpopulation of outliers with severe initial impairment who show little recovery. When these outliers were removed, clinical variables were good predictors of recovery among the remaining patients, showing a tight proportional relationship to initial impairment.

Inter-individual Variability in the Capacity for Motor Recovery After Ischemic Stroke. Publishing Authors By Initials

S Prabhakaran,E Zarahn,C Riley,A Speizer,JY Chong,RM Lazar,RS Marshall,JW Krakauer,S Prabhakaran,E Zarahn,C Riley,A Speizer,JY Chong,RM Lazar,RS Marshall,JW Krakauer,S Prabhakaran,E Zarahn,C Riley,A Speizer,JY Chong,RM Lazar,RS Marshall,JW Krakauer,

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PUBMED ID PMID:

MEDLINE DATE: 2008 Jan-Feb

Inter-individual Variability in the Capacity for Motor Recovery After Ischemic Stroke. Journal Published:

PUBLICATION TYPE: Journal Article

Journal: Neurorehabilitation and neural repair

VOLUME: 22

Page Numbers: 64-71

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ISSN: 1545-9683

DAY: 8

MONTH: 08

YEAR: 2007

Inter-individual Variability in the Capacity for Motor Recovery After Ischemic Stroke. Information

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LANGUAGE: eng

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Grant and Affiliation Information for Inter-individual Variability in the Capacity for Motor Recovery After Ischemic Stroke.

AFFILIATION: Neurological Institute, Columbia University, Stroke and Critical Care Division, New York, New York.

Country: United States

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MEDLINETA: Neurorehabil Neural Repair

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