Background/aims:
There is growing evidence that sleep disruption during neurorehabilitation is associated with worse motor recovery. However, the influence of sleep on upper limb motor outcomes, beyond predicted recovery potential (based on initial impairment and corticospinal tract integrity), is unclear. This study aimed to test whether sleep fragmentation, from actigraphy, explains additional variance in 6-month motor outcomes beyond predicted recovery.
Methods:
In this ongoing study (NCT05746260), patients are assessed within 7 days post-stroke using the Predicted Recovery Potential (PREP2) algorithm (target n=150). Follow-up assessments, at 1 and 6-months post-stroke, include sleep measured with actigraphy and self-report questionnaires, an overnight motor consolidation task, and clinical motor outcomes. This sub-analysis compares upper-limb outcomes across PREP2 categories and explores whether sleep fragmentation is a candidate measure to explain upper limb outcome variability beyond predicted recovery.
Results:
To-date 88 participants have been enrolled in the study (mean±SD age=72±12 years, NIHSS=8±5, 49 male). As expected, Action Research Arm Test (ARAT) score at 6-months post-stroke differs between PREP2 categories: “Excellent” category=52±8 (n=21); “good”=45±13 (n=17); “limited/poor”=21±6 (n=12). Preliminary analysis suggests that sleep fragmentation index explains a small proportion of additional variance in ARAT beyond PREP2 categorisation (R-squared=0.53 vs 0.45).
Conclusion:
Initial findings suggest sleep disruption measures may offer modest additional insight into motor recovery, warranting further data collection. A greater understanding of the role of sleep in recovery could help identify sleep‑focused targets for modulation during post‑stroke rehabilitation.