Is it possible to accurately predict outcome of a drop-foot in patients admitted to a hospital stroke unit?

Abstract

The aim of this study was to determine whether recovery from a drop-foot at 6 months can be predicted within 72 h after stroke and to investigate the effect of timing on the accuracy of prediction. One hundred and five patients with a first-ever anterior circulation stroke without full voluntary ankle dorsiflexion in standing position following the Fugl-Meyer motor score at 72 h were included for further analysis. Determinants were measured within 72 h, and at days 5 and 9 after stroke onset. Multivariable logistic regression analysis was used to predict the recovery of full ankle dorsiflexion while standing at 6 months. Having the item 'Motricity Index ankle dorsiflexion 19 or more (full range of motion ankle dorsiflexion againsts gravity)' was the best predictive variable. The sensitivity was 0.74 [95% confidence interval (CI) 0.62-0.80], specificity was 0.72 (95% CI 0.62-0.81), positive predictive value was 0.74 (95% CI 0.63-0.82), and negative predictive value was 0.71 (95% CI 0.60-0.80). No significant changes at day 5 and 9 after stroke were found. In stroke patients, the presence of full ankle dorsiflexion against gravity within 72 h is an accurate predictor for the absence of a drop-foot at 6 months. The accuracy of prediction of true positives and negatives is irrespective of the time of assessment in a stroke unit.