Article

OBJECTIVE: To determine the prognostic value of clinical assessment and motor
evoked potentials for upper limb strength and functional recovery after acute
stroke, and to establish the possible use of motor evoked potentials in
rehabilitation. DESIGN: A prospective study. SUBJECTS: Fifty-two patients with
hemiparesis were enrolled one month post-stroke; 38 patients concluded the study
at 12 months. METHODS: Motor evoked potentials were recorded at baseline and
after one month. Upper limb muscular strength (Medical Research Council Scale,
MRC) and functional tests (Frenchay Arm Test, Barthel Index) were used as
dependent outcome variables 12 months later. Motor evoked potentials were
classified as present or absent. Predictive values of motor evoked potentials and
MRC were evaluated. RESULTS: At 12 months, patients with baseline recordable
motor evoked potentials showed a good functional recovery (positive predictive
value 94%). The absence of motor evoked potentials did not exclude muscular
strength recovery (negative predictive value 95%). Motor evoked potentials had a
higher positive predictive value than MRC only in patients with MRC < 2.
CONCLUSION: Motor evoked potentials could be a supportive tool to increase the
prognostic accuracy of upper limb motor and functional outcome in hemiparetic
patients, especially those with severe initial paresis (MRC < 2) and/or with
motor evoked potentials absent in the post-stroke acute phase.

Langue : ANGLAIS