Brunnstrom recovery stage and motricity index for the evaluation of upper extremity in stroke: analysis for correlation and responsiveness

The aim of this study was to find out first whether Brunnstrom recovery stage (BRS) and motricity index NO were correlated with each other and second to observe whether the two assessment tools were sensitive to changes regarding the rehabilitation outcome. Forty-six stroke patients who were admitted to the Stroke Rehabilitation Unit at our Rehabilitation Centre were recruited. All measurements were made within the first 72 h of admission and on the last day of discharge. A physiotherapist performed all MI evaluations and a physiatrist blind to the results performed all BRS evaluations. Both upper extremity (UE) and hand BRS scores were found to be positively correlated with those of UE-MI; moreover, correlations between the discharge values were stronger than those between the admission values. The responsiveness of both the total scores of the BRS and UE-MI were strong (effect size d=0.97, Wilcoxon Z=5.33, P<0.001 for the UE-BRS; d=0.81, Z=5.09, P<0.001 for the hand BRS; d=0.91, Z=5.45, P<0.001 for the UE-MI). BRS and MI scores were found to be increased on discharge when compared with those of admission and the differences in between were statistically significant (P<0.001). BRS and MI seem to be well correlated and responsive concerning the evaluation of UEs in early stage stroke patients. Being convenient tests, they may easily be applied repetitively for close follow-up during rehabilitation.