Short-term recovery of limb muscle strength after acute stroke

Objectives: To document, by using norm-referenced strength measures, the recovery of limb muscle strength of patients undergoing stroke rehabilitation and to examine the relation between comorbidities and the recovery of strength after stroke. Design: Retrospective analysis of data from a consecutive convenience sample of patients examined clinically between 1994 and 1997, Setting: Acute inpatient rehabilitation unit. Participants: Fifty patients with stroke who were able to follow commands and were examined during acute rehabilitation by a single examiner (AWA). Interventions: Stroke rehabilitation emphasizing early movement, exercise with resistance, and daily functional activities. Main Outcome Measure: The strength at discharge of 7 muscle actions (shoulder abduction, elbow flexion, elbow extension, wrist extension, hip flexion, knee extension, ankle dorsiflexion) measured bilaterally with a hand-held dynamometer and compared with norm-referenced values. Results: Differences in strength between admission and discharge were significant for all muscle actions on the weaker side and for 4 of the 7 muscle actions on the stronger side. At discharge, the bilateral strength of all muscle actions was weaker than predicted by data from healthy individuals of comparable age, sex, and weight (F>17.000. P<.001). Strength did not differ between subjects who did and did not have a previous stroke or comorbidities. Conclusions: Subjects undergoing inpatient rehabilitation soon after stroke experienced an increase in limb muscle strength bilaterally. This increase was not influenced by previous stroke or comorbidities.