الفهرس 
IIMPACT OF POST STROKE DIFFERENT DISABIILIITIES ON FUNCTIONOnly 14 pages are availabe for public view
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Abstract
The objective of this study is to verify the clinical deficits that predict functional recovery of the upper extremity in acute ischemic stroke patients.
In our study we identified variables which reliably predict upper limb recovery. Such information would be useful to both clinicians and researchers to optimize rehabilitation, to clarify outcomes and the effects of therapy, to improve the design and analysis of clinical trials, to identify appropriate interventions, and to accurately inform patients of likely outcomes.
In the current study, 40 patients with acute ischemic stroke were recruited from El Sahel teaching hospital evaluation is done by history taking, examination, CT brain, clinical deficits of the affected upper extremity assessed in the first week; motor power by Medical research council (MRC scale),sensory disturbance by Nottingham Sensory Assessment, anosognosia by Anosognosia Score according to Bisiach et al. (Bisiach et al., 1986), ataxia by Ataxia Score according to Klockgether et al. (Klockgether et al., 1990), apraxia by (TULIA) test and upper extremity function in the first week and after three months duration assessed by Motor Assessment Scale (MAS). These data were correlated to our study included 13(32%) male and 27(68%) female, age ranged from 31 to 74 years old mean of age 58.45 ±SD 9.745.
MRC proximal and distal showed: 21(52.5%) of our study population were of weak power and 19 (47.5%) good power.
Tactile sensation showed: 23 (57.5%) of normal sensation, 12(30%) impaired sensation, and 5(12.5%) sever impaired.
Kinesthetic sensation showed: 27 (67.5%) of normal sensation, 5(12.5%) impaired sensation and 8(20%) no sensation.
Stereognosis showed: 29(72.5%) were normal, 2(5%) impaired sensation and 9(22.5%) absent sterognosis.
Anosognosia showed: 33(82.5%) had no anosognosia, 6(15%) mild anosognosia and 1(2.5%) moderate anosognosia.
Apraxia showed: 21(52.5%) patients of our study population couldn’t be assessed when motor power whether distal or proximal of weak power according MRC categorization, 8(20%) had no apraxia, 2(5%) mild apraxia and 9(22.5%) severe apraxia.
Ataxia showed: 21(52.5%) patients of our study population couldn’t be assessed when motor power whether distal or proximal of weak power according MRC, 12(30%) had no ataxia, 4(10%) mild ataxia, 2(5%) moderate ataxia and 1(2.5%) severe ataxia.
Hand function in the first week showed: 26(65%) had poor function and, 14(35%) good function and after three months 14(35%) poor function, 26(65%) good function.
Advanced hand activities in the first week showed: 29(72.5%) of poor function, 11(27.5%) good function and after three months 15(37.5%) poor function, 25(62.5%) good function.
Total MAS of upper extremity in the first week showed: 26(65%) were of poor function and, 14(35%) good function and after three months 14(35%) poor function, 26(65%) good function.
Our study found
• Highly significant improvements of upper extremity function after 3 months from stroke onset.
• Good motor power in the first week of stroke onset was highly significant with functionally recovery after three months.
• The patients with normal sensation (tactile, kinesthetic and sterognosis) in the first week of stroke onset was significant with function recovery after three months.
• The patients with no anosognosia in the first week of the stroke onset significant with function recovery after three months.
• By using Multi regression analysis, initial distal motor power (hand power) and kinesthetic sensation were good predictors for functional recovery of upper extremity.