Please use this identifier to cite or link to this item: https://doi.org/10.1159/000525984
Title: Association between Baseline NIHSS Limb Motor Score and Functional Recovery after Stroke: Analysis Based on a Multicountry Dataset
Authors: Chen C.L.H. 
Pokharkar Y.
Venketasubramanian N. 
for the CHIMES and CHIMES-E Investigators
Keywords: Clinical trial
MLC601
MLC901
NeuroAiD
NIHSS
Functional recovery
Motor impairment
Stroke
Issue Date: 29-Jul-2022
Publisher: S. Karger AG
Citation: Chen C.L.H., Pokharkar Y., Venketasubramanian N., for the CHIMES and CHIMES-E Investigators (2022-07-29). Association between Baseline NIHSS Limb Motor Score and Functional Recovery after Stroke: Analysis Based on a Multicountry Dataset. Cerebrovascular Diseases. ScholarBank@NUS Repository. https://doi.org/10.1159/000525984
Rights: Attribution-NonCommercial 4.0 International
Abstract: Introduction: Motor skills are the domains most often affected by stroke, but a comprehensive assessment of motor function is often impractical in the acute setting. It could be useful to have a brief simple tool allowing the stratification of patients at the time of inclusion in clinical studies. Hence, our primary objective was to evaluate whether the baseline NIH Stroke Scale limb motor score (b-NIHSS-LMS), obtained by summing the four motor items 5a to 6b of the NIHSS, is associated with functional recovery assessed by the modified Rankin Score (mRS). A secondary objective was to apply this new tool in the context of a clinical trial. Methods: The analysed population considered for this research included subjects from a large published, double-blind, multicentre trial, randomised to receive either a combination of various herbal and non-herbal components (MLC601) or placebo, administered within 72 h after an acute ischaemic stroke of intermediate severity (defined by baseline NIH Stroke Scale [b-NIHSS] score of 8–14). Associations between b-NIHSS-LMS and favourable outcome, i.e., mRS 0–1 at month 3, were evaluated using logistic regression adjusted for baseline covariates and study treatment. Results: The analysis included 533 subjects with an acute ischaemic stroke of intermediate severity assessed at month 3. Analyses showed that b-NIHSS-LMS was independently associated with a favourable outcome (OR 0.84; 95% confidence interval 0.76–0.92; p < 0.0003) at 3 months. Furthermore, in the clinical study considered, a selection of patients based upon a sufficient level of motor impairment at study entry (b-NIHSS-LMS ≥3) would result in the detection of a more pronounced and longer-lasting treatment effect. Indeed, ORs of treatment effect versus placebo in the selected subgroup (b-NIHSS-LMS ≥3) were statistically significant from months 3–24. Discussion/Conclusions: As an independent association between b-NIHSS-LMS and functional recovery after an acute ischaemic stroke of intermediate severity was established in this study, we suggest that the b-NIHSS-LMS can be used as a stratification factor in large clinical trials to define a target population with poststroke motor impairments.
Source Title: Cerebrovascular Diseases
URI: https://scholarbank.nus.edu.sg/handle/10635/233419
ISSN: 1015-9770
1421-9786
DOI: 10.1159/000525984
Rights: Attribution-NonCommercial 4.0 International
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