Prediction of lower extremity motor recovery in persons with severe lower extremity paresis after stroke

Objective: To investigate the extent of motor recovery and predict the prognosis of lower extremity (LE) recovery in patients with severe LE paresis after stroke Methods: 137 patients with severe LE paresis after stroke were recruited from a local medical centre. Voluntary LE movement was assessed with the LE subscale of the Stroke Rehabilitation Assessment of Movement (STREAM-LE). Univariate and stepwise regression analyses were used to investigate 25 clinical variables (including demographic, neuroimaging, and behavioural variables) for finding the predictors of LE recovery. Results: The STREAM-LE at discharge (DC_STREAM-LE) of the participants covered a very wide range (0–19). Specifically, 5.1% of the participants were nearly completely recovered, 11.7% were moderately recovered, 36.5% were slightly recovered, and 46.7% remained severely paralysed. ‘Score of STREAM-LE at admission (AD_STREAM-LE)’ and ‘volume of lesion and oedema’) were significant predictors of LE movement at discharge, explaining 25.1% of the variance of the DC_STREAM-LE (p < 0.001). Conclusions: LE motor recovery varied widely in our participants, indicating that patients’ recovery might not follow simple rules. The low predictive power (about a quarter) indicates that LE motor recovery in patients with severe LE paresis after stroke was hardly predictive.