Associated reactions of the upper extremity as an important part of neurological and functional assessment of patients in the acute phase of ischemic stroke

Background
Associated reactions (ARs) are involuntary movements that significantly affect the functioning of stroke patients. Due to a lack of scientific evidence, physiotherapists provide ARs therapy based mainly on individual experience. This common phenomenon remains poorly recognized among neurologists.

Aims
The aim was to assess the relationship between patient's ability to independently change positions within the bed and the occurrence of upper limb ARs in the rehabilitation process in the acute phase of ischemic stroke.

Material and methods
Group of 53 patients after an acute ischemic stroke underwent physiotherapeutic examinations. On the first day of the physiotherapy evaluation, the patient's ability to independently change positions within the bed was assessed. During the rehabilitation process, occurrence of the upper limb ARs was evaluated using the modified Associated Reaction Rating Scale (ARRS).

Results
It was reported that 20.75% of patients presented ARs of the upper limb during the rehabilitation process. Significant differences were found between patients with and without ARs when comparing the ability to shift to a long sitting position and to rotate on to the more affected side, examined on the first day of physiotherapy assessment.

Conclusions
Assessment of the patient's ability to change positions on the first day of physiotherapy can provide information that could help predict the occurrence of ARs. There is a need to adjust the ARRS for use in the acute phase of stroke. It is necessary to promote knowledge about ARs among neurologists and neurosurgeons.