Motor Function Recovery in Stroke Patients with Corona Radiata Infarct: 4 Case Studies

  • Kim, Chung-Sun (Department of Physical Therapy, College of Rehabilitation Science, Daegu University) ;
  • Kwon, Jung-Won (Department of Rehabilitation Science, Graduate School of Daegu University)
  • Received : 2010.05.07
  • Accepted : 2010.06.14
  • Published : 2010.06.25

Abstract

Purpose: The aim of this study was to use fMRI and clinical prognosis criteria to evaluate therapeutic interventions in stroke patients with corona radiata infarct and acquire fundamental information about recovery mechanisms. Methods: Four subjects (2 men, 2 women) who had strokes with corona radiata infarct were recruited. For all subjects, motor functions such as motricity index (MI), modified brunnstrom classification (MBC), functional ambulatory category (FAC), and bathel index (BI) were evaluated. Evaluations were done at least 4 times over a period of approximately 6~7 months from stroke onset. We compared the final evaluation with the first. Results: All patients with corona radiata infarct showed improvement in motor outcomes with the passing of time. The strength of all patients improved from zero or trace levels to normal or good levels in the MI (Motricity Index) test. Other motor outcomes including the modified brunnstrom classification (MBC), the functional ambulatory category (FAC), and the bathel index (BI) also improved with the passing of time. Conclusion: Stroke patients with corona radiata infarcts change for the better over time. Therefore, one can introduce clinical interventions by the aspect of progress in functional motor recovery.

Keywords

References

  1. Duncan PW, Goldstein LB, Matchar D et al. Measurement of motor recovery after stroke. Outcome assessment and sample size requirements. Stroke. 1992;23(8):1084-9. https://doi.org/10.1161/01.STR.23.8.1084
  2. Chang JS, Lee SY, Lee MH et al. The correlations between gait speed and muscle activation or foot pressure in stroke patients. J Kor Soc Phys Ther. 2009;21(3):47-52.
  3. Kautz SA, Patten C. Interlimb influences on paretic leg function in poststroke hemiparesis. J Neurophysiol. 2005;93(5): 2460-73. https://doi.org/10.1152/jn.00963.2004
  4. Broderick JP. William m. Feinberg lecture: Stroke therapy in the year 2025: Burden, breakthroughs, and barriers to progress. Stroke. 2004;35(1):205-11.
  5. Chen CL, Tang FT, Chen HC et al. Brain lesion size and location: Effects on motor recovery and functional outcome in stroke patients. Arch Phys Med Rehabil. 2000;81(4):447- 52. https://doi.org/10.1053/mr.2000.3837
  6. Jang SH, Kwon YH. Motor recovery in stroke patients. Yeungnam Univ J of Med. 2005;22(2):119-30. https://doi.org/10.12701/yujm.2005.22.2.119
  7. Kwakkel G, Kollen B, Twisk J. Impact of time on improvement of outcome after stroke. Stroke. 2006;37(9):2348-53. https://doi.org/10.1161/01.STR.0000238594.91938.1e
  8. Mohr JP. Lacunes. Stroke. 1982;13(1):3-11. https://doi.org/10.1161/01.STR.13.1.3
  9. Song YM. Distinct location of subcortical silent infarcts compared with symptomatic lacunar infarcts. J Neurol Sci. 2009;287(1-2):197-9. https://doi.org/10.1016/j.jns.2009.08.001
  10. Kumral E, Bayulkem G. Spectrum of single and multiple corona radiata infarcts: Clinical/mri correlations. J Stroke Cerebrovasc Dis. 2003;12(2):66-73. https://doi.org/10.1053/jscd.2003.11
  11. Cho SH, Kim DG, Kim DS et al. Motor outcome according to the integrity of the corticospinal tract determined by diffusion tensor tractography in the early stage of corona radiata infarct. Neurosci Lett. 2007;426(2):123-7. https://doi.org/10.1016/j.neulet.2007.08.049
  12. Jang SH. A review of corticospinal tract location at corona radiata and posterior limb of the internal capsule in human brain. NeuroRehabilitation. 2009;24(3):279-83.
  13. Misra UK, Kalita J. Central motor conduction studies in internal capsule and corona radiata infarction. J Neurol. 1997;244(9):579-85. https://doi.org/10.1007/s004150050147
  14. Shelton FN, Reding MJ. Effect of lesion location on upper limb motor recovery after stroke. Stroke. 2001;32(1):107-12.
  15. Jang SH. A review of motor recovery mechanisms in patients with stroke. NeuroRehabilitation. 2007;22(4):253-9.
  16. Jang SH. A review of the ipsilateral motor pathway as a recovery mechanism in patients with stroke. NeuroRehabilitation. 2009;24(4):315-20.
  17. Kwon YH, Lee CH, Ahn SH et al. Motor recovery via the peri-infarct area in patients with corona radiata infarct. NeuroRehabilitation. 2007;22(2):105-8.
  18. Jang SH, Ahn SH, Ha JS et al. Peri-infarct reorganization in a patient with corona radiata infarct: A combined study of functional mri and diffusion tensor image tractography. Restor Neurol Neurosci. 2006;24(2):65-8.
  19. Demeurisse G, Demol O, Robaye E. Motor evaluation in vascular hemiplegia. Eur Neurol. 1980;19(6):382-9. https://doi.org/10.1159/000115178
  20. Brunnstrom S. Motor testing procedures in hemiplegia: Based on sequential recovery stages. Phys Ther. 1966;46(4):357-75. https://doi.org/10.1093/ptj/46.4.357
  21. Cunha IT, Lim PA, Henson H et al. Performance-based gait tests for acute stroke patients. Am J Phys Med Rehabil. 2002; 81(11):848-56. https://doi.org/10.1097/00002060-200211000-00008
  22. Laake K, Laake P, Ranhoff AH et al. The barthel adl index: Factor structure depends upon the category of patient. Age Ageing. 1995;24(5):393-7. https://doi.org/10.1093/ageing/24.5.393
  23. Sainsbury A, Seebass G, Bansal A et al. Reliability of the barthel index when used with older people. Age Ageing. 2005; 34(3):228-32. https://doi.org/10.1093/ageing/afi063
  24. Witte OW. Lesion-induced plasticity as a potential mechanism for recovery and rehabilitative training. Curr Opin Neurol. 1998;11(6):655-62. https://doi.org/10.1097/00019052-199812000-00008
  25. Han BS, Hong JH, Hong C et al. Location of the corticospinal tract at the corona radiata in human brain. Brain Res. 2010;1326:75-80. https://doi.org/10.1016/j.brainres.2010.02.050
  26. Jang SH. The role of the corticospinal tract in motor recovery in patients with a stroke: A review. NeuroRehabilitation. 2009;24(3):285-90.
  27. Song YM. Somatotopic organization of motor fibers in the corona radiata in monoparetic patients with small subcortical infarct. Stroke. 2007;38(8):2353-5. https://doi.org/10.1161/STROKEAHA.106.480632
  28. Park JW. Longitudinal motor function recovery in stroke patients with focal pons infarction: Report of 4 cases. J Kor Soc Phys Ther. 2009;21(4):111-5.