Predicting activities after stroke

Knowledge about the functional prognosis of stroke patients admitted to a stroke unit has increased substantially over the past years. Prospective cohort studies suggest that the return of some finger extension and voluntary activity in the shoulder abductors within days post-stroke onset predicts a favourable recovery of the upper extremity function at 6 months. The Barthel index and the ability to sit unsupported are the main predictors for recovery of gait and activities of daily living (ADL) independency. Almost all developed prediction models identify patients with a favourable prognosis but are less suitable to predict accurately individuals who will not regain dexterity, mobility, and ADL independence following stroke. In individuals with an unfavourable prognosis, this entails measuring clinical determinants frequently and longitudinally during the post-stroke course. Moreover, future research should focus on cross-validating prediction models, which should also incorporate presently excluded stroke subtypes, such as brain stem strokes, intraparenchymal, and subarachnoid haemorrhages.