STROKE-TWITCHELL (1951) STAGES OF MOTOR RECOVERY

SUMMARY

1. Immediately following stroke: flaccid paralysis & areflexia. Arm worse than leg.

2. Within 48hrs: increased deep tendon reflexes on the involved side.

3. Spasticity: in the flexors & adductors of UL, extensors & adductors of LL on the involved side.

4. As spasticity increases 1-38 days post-stroke: ankle clonus appears.

5. 6-33 days post-stroke: intentional movement (shoulder flexion) appears.

6. Recovery of movement: flexor synergy pattern (shoulder, elbow, wrist, finger flexion) first, followed by extensor synergy pattern.

7. Most recovery occurs in 3 months with motor recovery in the leg occurring earlier & being more complete than the arm.

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].