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Trajectory of Motor Performance Over Twelve Months in Nigerian Stroke Survivors

Objective: Submissions on recovery of post-stroke motor performance vary, especially in relation to increasing time after stroke. This study examined the trajectory of motor performance over the first 12 months after stroke. Methods: Consecutive first-incidence stroke survivors (N = 83) were recruited within 1 month of onset from a tertiary health institution in Nigeria. Simplified Fugl Meyer scale (S-FM) was used to assess motor performance at monthly intervals. Changes in overall motor performance, and differences between the affected upper and lower extremities, were examined using Friedman's ANOVA and paired t-tests, respectively. Results: Significant improvement in motor performance was observed across 12 months (p < .001), with the proportion of stroke survivors with severe impairment at onset (53.3%) decreasing to 20% by 12 months. Lower extremity motor performance scores were significantly higher than for the upper extremity from 1 to 12 months (p <.01 at 3, 4, 5, 6 and 12 months; and p < .05 at the remaining months). Conclusions: The potential for long-term improvement in motor performance after stroke was observed, suggesting that this can be harnessed by long-term rehabilitation efforts. The comparatively poorer outcome in the upper extremity indicates the need for extra rehabilitation strategies to enhance upper-extremity motor recovery in the first year of stroke.