Prediction of upper limb activity limitation at 6 monthsafter stroke

Introduction: Accurate prediction of upper limb (UL) activity limitation (AL) after stroke enables effective treatment and preparation of patients for living with consequences of stroke. Few studies have used AL measures in acute stroke to predict UL activity outcomes.This study aimed to investigate predictive strength of early AL in predicting UL AL at 6 months post-stroke.Method:Patients diagnosed with acute stroke (n=106) were assessed at 2–4 weeks (T1), 2 months (T2) and 6 months (T3). UL Measures included Action Research Arm Test (ARAT), Nine Hole Peg Test(9HPT). Modified Barthel Index (MBI) measured ADL activity.Dependent variables were ARAT outcomes at T2 and T3 with 18 selected potential T1 and T2 independent variables.Results:For T2 ARAT, T1 ARAT, MBI, days to assessment and pres-ence of total anterior circulation stroke explained 68% variance(R2=0.68; F6,89=22.9; p<0.001). For T3 ARAT, T1 ARAT and MBI scores explained 64% of variance (R2=0.64; F9,87=17.06; p<0.001)with T2 ARAT alone predicting 93% variance (R2=0.93; F8,73=126.5;p<0.001). With T2 ARAT removed from that model, 9HPT and MBI explained 72% variance in T3 ARAT (R2=0.72; F7,74=31.2; p<0.001).Conclusion:UL activity limitation measured on the ARAT and MBI scores before 1 month post-stroke give a good indication of likelyUL outcome at 2 and 6 months. ARAT score at 2 months providesbest prediction at 6 months, with the MBI and 9HPT as strong predictors when the ARAT is removed. Therapists can now predict UL activity limitation at 6 months with known certainty on commonly used clinical outcome measures.