Late motor recovery is influenced by muscle tone changes after stroke

Objectives: To evaluate the time course of motor recovery in a poststroke period ranging from 2 to 6 months and its correlation with both the severity of motor deficit and the muscle tone disturbances (flaccidity or spasticity) of the affected limbs. Design: Prospective cohort study. Setting: A comprehensive rehabilitation hospital. Participants: Forty consecutive stroke patients (21 men, 19 women) with first ischemic stroke who met the inclusion criteria. Interventions: Not applicable. Main Outcome Measure: Change in motor deficit as evaluated by the Adams Hemispheric Stroke Scale. Results: Stepwise regression analysis indicated that the most significant factors influencing motor recovery were the time elapsed since stroke and muscle tone. Conclusions: Rehabilitation of stroke patients is more effective in the first months after the event rather than later, considering the significant correlation observed between motor recovery and time elapsed since stroke. Flaccid patients appear to need 3 months or more before reaching the final plateau, because motor recovery occurs later and/or proceeds more slowly, whereas outcomes for spastic patients with spasticity appears to occur in the first months after stroke.