[Prediction of restoration of functional activity of paretic limbs in patients who have suffered an ischemic stroke].

Abstract

The World Stroke Organization notes the growing number of strokes worldwide. Motor disorders in the paretic limbs are one of the most common consequences of stroke, which significantly affects the quality of patients' daily lives. The possibility of early prediction of clinical and functional recovery of patients after stroke is an important component of the rehabilitation process.

Objective: To develop a model for predicting the restoration of the functional activity of paretic limbs and mobility of patients in the early recovery period of ischemic stroke and to evaluate the results of rehabilitation with a positive and negative prognosis.

Material and methods: The prognostic factors used were the results of an assessment of motor disorders, balance function on the Fugl-Meyer scale and interhemispheric brain activity (Brain symmetry indices in standard electroencephalogram leads), as well as the patient's age, prescription of stroke, and level of vital activity at the time of examination. The functional activity of paretic limbs and mobility of patients were assessed using validated scales (Action Research Arm Test, Modified Frenchay scale, Wolf Motor Function Test, Rivermead mobility index, Hauser ambulance index, Functional Independence Measurement). The TIBCO Software Inc. (2017) program was used to build the model, Statistica, version 13. The Mann-Whitney criterion was used to identify differences between subgroups.

Results: A new method for predicting the functional recovery of paretic limb activity after ischemic stroke has been developed (patent RU2825714C1, publ. 08/28/2024). The forecast model developed by the logistic regression method is statistically significant (χ²=43.26; p<0.001. Operational characteristics of the test (training sample of 91 patients): sensitivity - 84%, specificity - 83%, diagnostic accuracy - 84%. After rehabilitation, a statistically significantly greater increase in the indicators of functional activity of paretic limbs and mobility was revealed in patients with a positive prognosis compared with a subgroup of patients with a negative prognosis.

Conclusions: The obtained model makes it possible to predict the recovery of patients' activity in terms of self-care and movement in the first six months after an ischemic stroke in the presence of limb paresis.