Stroke
Conditions
Keywords
Upper Extremity, Cohort Studies, Prognosis
Brief summary
Upper limb recovery after stroke is highly predictable early after stroke. Nijland et al. showed that based on two simple clinical bedside tests - 'Shoulder Abduction' and 'Finger Extension' (the so called 'SAFE model' \[Stinear et al., 2012\]) - measured within the first 72 hours after stroke, \ 87% of the patients could be correctly classified as either regaining or not regaining some dexterity (recoverers or nonrecoverers, respectively) (Nijland et al., 2010). This kind of information regarding the patients' functional prognosis allows proper discharge planning, setting realistic rehabilitation goals, and adequate patient information. However, the length of hospital stay after stroke has been decreasing. Therefore, knowledge is needed regarding the ability to make an accurate first prediction within the first 24 hours after stroke onset while using simple clinical bedside assessments. This would facilitate an earlier triage and with that, an accelerated and smooth transition of patients within the stroke care continuum. In addition, a first prediction within 24 hours poststroke has the potential to decrease health care expenses, as length of hospital stay after an acute stroke is \ 30% of the total costs (i.e., direct and indirect costs) associated with stroke (Roger et al., 2012; Fattore et al., 2012). The primary objective of aRISE is to determine the ability of the behavioral biometric impairments 'Shoulder Abduction' and 'Finger Extension' measured \<24 hours poststroke to predict outcome of upper limb capacity 3 months after stroke. The secondary aim is to investigate the the added value of other simple clinical bedside tests for predicting outcome of upper limb capacity 3 months poststroke. aRISE is a prospective longitudinal observational cohort study of 40 first-ever ischemic stroke patients, who will be assessed \<24 hours, 7 days and 3 months after stroke onset.
Interventions
BEHAVIORALAssessment of behavioral biometric impairments
Assessment of behavioral biometric impairments
Sponsors
University of Zurich
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* First-ever unilateral ischemic stroke in the middle cerebral artery territory \<48 hours, confirmed by MRI-DWI and/or CT * Age 18 years or older * Able to follow one-staged commands * NIHSS arm score ≥1 * Informed consent after participants' information
Exclusion criteria
* Modified Rankin Scale score \>2 before stroke * Neurological or other diseases affecting the upper limb(s) before stroke * Intravenous line in the upper limb(s) which limits assessment * Contra-indications on ethical grounds * Expected or known non-compliance to participate in the observational study, severe drug or/and alcohol abuse
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Action Research Arm Test | 3 months poststroke | Upper limb capacity |
| Fugl-Meyer Assessment | 3 months poststroke | Upper limb motor function |
| Motricity Index | 3 months poststroke | Upper limb motor function |
Other
| Measure | Time frame | Description |
|---|---|---|
| Trunk Control Test | 48 hours, 7 days, and 3 months poststroke | Sitting balance |
| Functional Ambulation Categories | 48 hours, 7 days, and 3 months poststroke | Walking ability (independence) |
| Modified Rankin Scale | 48 hours, 7 days, and 3 months poststroke | Global disability |
| Surface Electromyography | 48 hours, 7 days, and 3 months poststroke | Forearm skeletal muscle electric activity |
| Global Rating of Perceived Changes | 3 months poststroke | — |
| Concomitant Movement Therapy | 48 hours, 7 days, and 3 months poststroke | Intensity of therapy based on charts |
| Safety | 48 hours, 7 days, and 3 months poststroke | Serious Events (1. death; 2. life-threatening illness or injury; 3. in-patient or prolonged hospitalisation; 4. medical or surgical intervention to prevent life threatening illness; 5. led to fetal distress, death or a congenital abnormality or birth defect) |
| Motor Activity Log - 14 | 48 hours, 7 days, and 3 months poststroke | Patient-reported daily life upper limb use |
| Movement Sensors | 48 hours, 7 days, and 3 months poststroke | Upper limb range of motion patterns |
| National Institutes of Health Stroke Scale | 48 hours, 7 days, and 3 months poststroke | Neurological functions |
Countries
Switzerland
Outcome results
None listed