Background This observational study examined whether lower limb (LL) motor-evoked potentials (MEPs) 1 week post-stroke predict recovery of independent walking, use of ankle-foot orthosis (AFO) or walking aid, at 3 and 6 months post-stroke. Methods Non-ambulatory participants were recruited 5 days post-stroke. Transcranial magnetic stimulation was used to determine tibialis anterior MEP status and clinical assessments (age, National Institutes of Health Stroke Scale (NIHSS), ankle dorsiflexion strength, LL motricity index, Berg Balance Test) were completed 1 week post-stroke. Functional Ambulation Category (FAC), use of AFO and walking aid were assessed 3 months and 6 months post-stroke. MEP status, alone and combined with clinical measures, and walking outcomes at 3 and 6 months were analysed with Pearson χ2 and multivariate binary logistic regression. Results Ninety participants were included (median age 72 years (38–97 years)). Most participants (81%) walked independently (FAC ≥ 4), 17% used an AFO, and 49% used a walking aid 3 months post-stroke with similar findings at 6 months. Independent walking was better predicted by age, LL strength and Berg Balance Test (accuracy 92%, 95% CI 85% to 97%) than MEP status (accuracy 73%, 95% CI 63% to 83%). AFO use was better predicted by NIHSS and MEP status (accuracy 88%, 95% CI 79% to 94%) than MEP status alone (accuracy 76%, 95% CI 65% to 84%). No variables predicted use of walking aids. Conclusions The presence of LL MEPs 1-week post-stroke predicts independent walking at 3 and 6 months post-stroke. However, the absence of MEPs does not preclude independent walking. Clinical factors, particularly age, balance and stroke severity, more strongly predict independent walking than MEP status. LL MEP status adds little value as a biomarker for walking outcomes. Data are available on reasonable request. All data are available on reasonable request.

中文翻译：

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下肢运动诱发电位可以预测中风后的步行结果吗？


背景 这项观察性研究检验了中风后 1 周下肢 (LL) 运动诱发电位 (MEP) 是否可以预测中风后 3 个月和 6 个月时独立行走、使用踝足矫形器 (AFO) 或助行器的恢复情况。方法 中风后 5 天招募不能行走的参与者。经颅磁刺激用于确定胫骨前肌 MEP 状态，并在中风后 1 周完成临床评估（年龄、美国国立卫生研究院卒中量表 (NIHSS)、踝背屈强度、LL 运动指数、Berg 平衡测试）。中风后 3 个月和 6 个月对功能性行走类别 (FAC)、AFO 和助行器的使用进行评估。使用 Pearson χ2 和多变量二元逻辑回归分析单独和与临床测量相结合的 MEP 状态以及 3 个月和 6 个月时的步行结果。结果 纳入 90 名参与者（中位年龄 72 岁（38-97 岁））。大多数参与者 (81%) 能够独立行走 (FAC ≥ 4)，17% 使用 AFO，49% 在中风后 3 个月使用助行器，6 个月时发现类似结果。通过年龄、LL 力量和 Berg 平衡测试（准确度 92%，95% CI 85% 至 97%）比 MEP 状态（准确度 73%，95% CI 63% 至 83%）更好地预测独立行走。 NIHSS 和 MEP 状态（准确度 88%，95% CI 79% 至 94%）比单独 MEP 状态（准确度 76%，95% CI 65% 至 84%）更好地预测 AFO 使用。没有变量预测助行器的使用。结论 中风后 1 周出现 LL MEP 可以预测中风后 3 个月和 6 个月的独立行走能力。然而，欧洲议会议员的缺席并不妨碍独立行走。临床因素，特别是年龄、平衡能力和中风严重程度，比 MEP 状态更能预测独立行走。 LL MEP 状态作为步行结果的生物标志物几乎没有什么价值。可根据合理要求提供数据。所有数据均可根据合理要求提供。