- •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.
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.
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.
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.
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Published online: January 06, 2023
Accepted: December 7, 2022
Received in revised form: December 2, 2022
Received: September 14, 2022
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