Highlights
- •We explored the convalescent rehabilitation outcomes after LSA-BAD and PPA-BAD with both neurological severity and ADLs.
- •Convalescent rehabilitation outcomes of BAD should be assessed in terms of improvements in pure-motor hemiparesis and ADLs.
- •The disturbance patterns in the corticospinal tract by ischemic lesions may be different between LSA-BAD and PPA-BAD.
Abstract
Purpose
We investigated inpatient convalescent rehabilitation outcomes of Branch atheromatous
disease (BAD).
Subjects and methods
The subjects were 116 patients with lenticulostriate artery territory - BAD (LSA-BAD)
and 29 with paramedian pontine artery territory - BAD (PPA-BAD). For all patients,
the National Institutes of Health Stroke Scale (NIHSS), Functional Independence Measure
(FIM) scores, and Brunnstrom recovery stages (BRS) of the upper limb, fingers, and
lower limb were measured on admission and at discharge.
Results
There were no significant differences in clinical characteristics on admission between
the LSA-BAD and PPA-BAD groups. The neurological severity of PPA-BAD, as measured
by the NIHSS, was significantly milder compared with that of LSA-BAD upon admission
(p = 0.015) and at discharge (p = 0.001). Patients with LSA-BAD had significantly
less improvement in the BRS of the upper limb (p = 0.001), fingers (p < 0.001), and
lower limb (p = 0.007) at discharge. Furthermore, they had significantly smaller changes
in BRS between admission and discharge for the upper limb (p = 0.033) and fingers
(p = 0.014) compared with patients with PPA-BAD. The improvement in BRS for patients
with LSA-BAD tended to be limited to two stages; however, both patients with LSA-BAD
and PPA-BAD saw sufficient gains in FIM at discharge.
Conclusion
Rehabilitation outcomes following BAD in the convalescent period should be assessed
in terms of improvements in pure-motor hemiparesis and activities of daily living.
Furthermore, the disturbance patterns in the corticospinal tract by ischemic stroke
lesions may be different between LSA-BAD and PPA-BAD.
Keywords
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Article info
Publication history
Published online: January 06, 2023
Accepted:
December 7,
2022
Received in revised form:
December 2,
2022
Received:
September 14,
2022
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2022.106937
Copyright
© 2022 Elsevier Inc. All rights reserved.
