BACKGROUND: Stroke often impairs upper extremity motor function, with recovery in the sub-acute phase being crucial for regaining independence. This study examines changes in isometric muscle strength, dexterity, and self-care independence during this period, and evaluates the effects of a comprehensive intensive rehabilitation (COMIRESTROKE). METHODS: Individuals in sub-acute stroke recovery and age- and sex-matched controls were assessed for pre- and post-rehabilitation differences in primary outcomes (grip/pinch strength, Nine Hole Peg Test [NHPT], Action Research Arm Test [ARAT]). COMIRESTROKE's effects on primary and secondary outcomes (National Institute of Health Stroke Scale [NIHSS], Modified Rankin Scale [MRS], Functional Independence Measure [FIM]) were evaluated. Outcomes were analyzed for dominant and non-dominant limbs, both regardless of impairment and with a focus on impaired limbs. RESULTS: Fifty-two individuals with stroke (NIHSS 7.51 ± 5.71, age 70.25 ± 12.66 years, 21.36 ± 12.06 days post-stroke) and forty-six controls participated. At baseline, individuals with stroke showed significantly lower strength (dominant grip, key pinch, tip-tip pinch, padj < 0.05), higher NHPT scores (padj < 0.05), and lower ARAT scores (padj < 0.001). COMIRESTROKE led to improvements in dominant key pinch, non-dominant tip-tip pinch, NHPT, and both dominant and non-dominant ARAT (padj < 0.05). Notably, non-dominant key pinch improved significantly when considering only impaired hands. Pre- and post-test differences between groups were significant only for ARAT (both limbs), even after adjustment (padj < 0.05). All secondary outcomes (NIHSS, MRS, FIM) showed significant improvement post-COMIRESTROKE (padj < 0.001). CONCLUSION: Individuals with stroke exhibit reduced muscle strength and dexterity, impairing independence. However, comprehensive intensive rehabilitation significantly improves these functions. Data are available from the corresponding author upon request and are part of a sub-study of NCT05323916.

Center of Scientific Information 3rd Faculty of Medicine Charles University Prague Czechia

Department of Neurology 3rd Faculty of Medicine Charles University and Thomayer University Hospital Prague Czech Republic

Department of Rehabilitation and Sports Medicine 2nd Medical Faculty Charles University and University Hospital Motol Prague Czech Republic

Department of Rehabilitation Medicine 3rd Faculty of Medicine Charles University Prague Czechia

Department of Rheumatology and Physiotherapy 3rd Faculty of Medicine Charles University and Thomayer University Hospital Prague Czech Republic

Department of Statistical Modelling Institute of Computer Science of the Czech Academy of Sciences Prague Czechia

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