Impact of Time on Improvement of Outcome After Stroke
Open accessAbstract
Background and Purpose— Longitudinal conducted studies show that neurologic and functional recovery show faster recovery in the first weeks poststroke. The aim of the present study was to study the effects of progress of time on observed improvements in motor strength, synergisms, and activities during the first 16 weeks poststroke. Methods— Based on data from a previous study, 101 patients with first-ever ischemic middle cerebral artery strokes were prospectively investigated during the first 16 weeks after stroke. Progress of time was categorized into 8 biweekly time intervals and was used as the independent covariate in a first-order longitudinal regression model. The biweekly time change (progress of time) was related to improvement in upper and lower limb motor recovery assessed with Fugl-Meyer score and Motricity Index, reduction in visuospatial inattention based on the letter cancellation task, and improvement in walking ability, dexterity, and activities of daily living measured with the Functional Ambulation Categories, Action Research Arm test, and Barthel Index. Results— Time explained a significant change of 8.4 (42%) measurement units on the Barthel Index for the first 10 weeks poststroke, 1.1 (22%) measurement units on Functional Ambulation Categories, and 19% on the Action Research Arm test for the first 6 and 8 weeks poststroke. Approximately 25% (for Fugl-Meyer-arm) to 26% (for Motricity Index-arm) of the significant change in measurements units was explained by time alone for the upper limb compared with 33% for Fugl-Meyer-leg and 39% for Motricity Index-leg of the lower limb. Time accounted for a reduction of 16% in the letter cancellation task. Observed associations did not change after controlling for covariates such as age, gender, hemisphere of stroke, type of stroke, or intervention. Conclusion— Progress of time is an independent covariate that reflects spontaneous recovery of body functions and activities explaining &16% to 42% of the observed improvements in the first 6 to 10 weeks after stroke onset.
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Adaptation strategies already start as soon as patients learn to accomplish functional tasks within the first weeks poststroke.
“These adaptation strategies already start as soon as patients learn to accomplish functional tasks within the first weeks poststroke.58”
From The Effectiveness of the Bobath Concept in Stroke Rehabilitation: What is the Evidence? (2009) · cites this paper as [58]
The Discussion (page unavailable) links learning adaptation strategies to acquiring functional tasks such as gait and daily activities. It places that explanation in the context of functional progress after three months, however, and does not establish that the strategies start within the first weeks poststroke. (LLM, conf=0.84)
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Cites
Clinical Gait Assessment in the Neurologically Impaired
Holden, M. K., Gill, K. M., Magliozzi, M. R., Nathan, J., & Piehl-Baker, L. (1984) · Physical Therapy · doi:10.1093/ptj/64.1.35 · Cited by 1,499 · see citing works
Probability of Regaining Dexterity in the Flaccid Upper Limb
Kwakkel, G., Kollen, B. J., van der Grond, J., & Prevo, A. J. H. (2003) · Stroke · doi:10.1161/01.str.0000087172.16305.cd · Cited by 1,409 · see citing works
Self-citationLyle, R. C. (1981) · International Journal of Rehabilitation Research · doi:10.1097/00004356-198112000-00001 · Cited by 1,335 · see citing works
Applied Longitudinal Data Analysis for Epidemiology: A Practical Guide
Twisk, J. W. R. (2003) · Cited by 1,244 · see citing works
Self-citationReliability of the Fugl-Meyer Assessment of Sensorimotor Recovery Following Cerebrovascular Accident
Duncan, P. W., Propst, M., & Nelson, S. G. (1983) · Physical Therapy · doi:10.1093/ptj/63.10.1606 · Cited by 962 · see citing works
Jørgensen, H. S., Nakayama, H., Raaschou, H. O., Vive-Larsen, J., Støier, M., & Olsen, T. S. (1995) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/s0003-9993(95)80568-0 · Cited by 947 · see citing works
Intensity of leg and arm training after primary middle-cerebral-artery stroke: a randomised trial
Kwakkel, G., WAGENAAR, R. C., Twisk, J. W. R., Lankhorst, G. J., & Koetsier, J. C. (1999) · The Lancet · doi:10.1016/s0140-6736(98)09477-x · Cited by 931 · see citing works
Self-citationDobkin, B. H. (2005) · New England Journal of Medicine · doi:10.1056/nejmcp043511 · Cited by 917 · see citing works
Measurement of motor recovery after stroke. Outcome assessment and sample size requirements.
Duncan, P. W., Goldstein, L. B., Matchar, D. B., Divine, G., & Feussner, J. R. (1992) · Stroke · doi:10.1161/01.str.23.8.1084 · Cited by 746 · see citing works
Understanding the pattern of functional recovery after stroke: Facts and theories
Kwakkel, G., Kollen, B., & Lindeman, E. (2004) · Restorative Neurology and Neuroscience · doi:10.3233/rnn-2004-00282 · Cited by 727 · see citing works
Self-citationMobility after stroke: Reliability of measures of impairment and disability
Collen, F. M., Wade, D. T., & Bradshaw, C. M. (1990) · International Disability Studies · doi:10.3109/03790799009166594 · Cited by 668 · see citing works
Skilbeck, C. E., Wade, D. T., Hewer, R. L., & WOOD, V. A. (1983) · Journal of Neurology Neurosurgery & Psychiatry · doi:10.1136/jnnp.46.1.5 · Cited by 516 · see citing works
Defining post-stroke recovery: implications for design and interpretation of drug trials
Duncan, P. W., Lai, S. M., & Keighley, J. D. (2000) · Neuropharmacology · doi:10.1016/s0028-3908(00)00003-4 · Cited by 409 · see citing works
Multilevel modelling of medical data
Goldstein, H., Browne, W. J., & Rasbash, J. (2002) · Statistics in Medicine · doi:10.1002/sim.1264 · Cited by 388 · see citing works
Similar motor recovery of upper and lower extremities after stroke.
Duncan, P. W., Goldstein, L. B., Horner, R. D., Landsman, P. B., Samsa, G. P., & Matchar, D. B. (1994) · Stroke · doi:10.1161/01.str.25.6.1181 · Cited by 387 · see citing works
Predicting Improvement in Gait After Stroke: A Longitudinal Prospective Study
Kollen, B., van de Port, I., Lindeman, E., Twisk, J., & Kwakkel, G. (2005) · Stroke · doi:10.1161/01.str.0000190839.29234.50 · Cited by 269 · see citing works
Self-citationThe Process of Recovery: After Hemiplegia
NEWMAN, M. (1972) · Stroke · doi:10.1161/01.str.3.6.702 · Cited by 98 · see citing works
Improving the Action Research Arm test: a unidimensional hierarchical scale
van der Lee, J. H., Roorda, L. D., Beckerman, H., Lankhorst, G. J., & Bouter, L. M. (2002) · Clinical Rehabilitation · doi:10.1191/0269215502cr534oa · Cited by 97 · see citing works
Gresham, G. E. (1986) · Stroke · doi:10.1161/01.str.17.3.358 · Cited by 92 · see citing works
Clinical examination in diagnosis and subclassification of stroke
Bamford, J. (1992) · The Lancet · doi:10.1016/0140-6736(92)90085-h · Cited by 89 · see citing works
Flagged first, then by citations
Research works printed but not linked: 1
- Twisk JWR. Applied Longitudinal Data Analysis for Epidemiology. Cam- bridge University Press; 2003.
Cited by
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Langhorne, P., Bernhardt, J., & Kwakkel, G. (2011) · The Lancet · doi:10.1016/s0140-6736(11)60325-5 · Cited by 2,726 · see citing works
Self-citationMotor learning principles for neurorehabilitation
(2013) · Handbook of Clinical Neurology · doi:10.1016/b978-0-444-52901-5.00008-3 · Cited by 401 · see citing works
The Effectiveness of the Bobath Concept in Stroke Rehabilitation: What is the Evidence?
Kollen, B. J., Lennon, S., Lyons, B., Wheatley-Smith, L., Scheper, M., Buurke, J. H., Halfens, J., Geurts, A. C. H., & Kwakkel, G. (2009) · Stroke · doi:10.1161/strokeaha.108.533828 · Cited by 274 · see citing works
Self-citationBehavioural clusters and predictors of performance during recovery from stroke
Ramsey, L. E., Siegel, J. S., Lang, C. E., Strube, M., Shulman, G. L., & Corbetta, M. (2017) · Nature Human Behaviour · doi:10.1038/s41562-016-0038 · Cited by 219 · see citing works
Recovery of Gait After Stroke: What Changes?
Buurke, J. H., Nene, A. V., Kwakkel, G., Erren-Wolters, V., IJzerman, M. J., & Hermens, H. J. (2008) · Neurorehabilitation and Neural Repair · doi:10.1177/1545968308317972 · Cited by 137 · see citing works
Self-citation
- Authors
- Kwakkel, G., Kollen, B., & Twisk, J.
- Affiliations
- University Medical Center Utrecht (NL)
- Venue
- Stroke
- Published
- 2006-09
- Volume
- 37
- Issue
- 9
- Pages
- 2348-2353
- ISSN
- 0039-2499 (ISSN-L)
- 1524-4628
- OpenAlex
- W2159053241
- Cited by
- 533
- References
- 20
- Citations by year
- 2026: 28 · 2025: 27 · 2024: 41 · 2023: 33 · 2022: 27 · 2021: 33 · 2020: 30 · 2019: 32 · 2018: 27 · 2017: 28 · 2016: 35 · 2015: 24 · 2014: 32 · 2013: 29 · 2012: 28
- FWCI
- 16.14
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Stroke (publishedVersion)
- PubMed (publishedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
- VU Research Portal (publishedVersion, other-oa)
- Digital Academic REpository of VU University Amsterdam (Vrije Universiteit Amsterdam) (submittedVersion)
- Pure Amsterdam UMC (submittedVersion)
- Radboud Repository (Radboud University) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Funders
- ZonMw
- Topics
- Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
- Health Sciences › Medicine › Epidemiology › Acute Ischemic Stroke Management
- Health Sciences › Health Professions › Speech and Hearing › Dysphagia Assessment and Management
- Keywords
- stroke recovery, stroke onset time, spontaneous recovery, motor recovery, activities of daily living, walking ability, ischemic stroke, middle cerebral artery stroke, Fugl-Meyer Assessment, Motricity Index, Barthel Index, Functional Ambulation Category, Action Research Arm Test
- MeSH terms
- Activities of Daily Living, Adult, Aged, Aged, 80 and over, Arm, Humans, Leg, Middle Aged, Movement, Time Factors, Walking, Recovery of Function, Stroke
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