Comparative Effects of the Motor Relearning Program on Functional Recovery in Hemorrhagic versus Ischemic Stroke Survivors- A Cohort study

Abstract

Background: Stroke is a major global health issue, affecting 15 million people annually, with 5 million deaths and another 5 million left permanently disabled. In India, incidence ranges from 84–262 per 100,000, driven by demographic and lifestyle changes. Both ischemic and hemorrhagic strokes differ in recovery, but motor impairments severely limit independence. The Motor Relearning Program (MRP), developed by Carr and Shepherd, focuses on task-specific practice, feedback, and real-life transfer of skills. This study aimed to compare MRP’s effectiveness on functional recovery in ischemic versus hemorrhagic stroke survivors using the Motor Assessment Scale (MAS) and Free Functional Scale (FFS).

Methods: Based on Indian prevalence data (ischemic ~75%, hemorrhagic ~25%), the calculated sample size was ~72 per group (~144 total) using a 95% confidence level and a 10% margin of error. Accordingly, 144 patients were recruited (ischemic = 72; hemorrhagic = 72). Both groups received MRP interventions for four weeks. Outcomes were measured using MAS and FFS at baseline, week 1, week 2, week 3, and week 4.

Results: Both groups demonstrated significant improvements in MAS and FFS scores. Hemorrhagic stroke survivors showed greater gains compared to ischemic survivors, particularly from the second week onwards.

Conclusion: MRP is an effective rehabilitation strategy for both ischemic and hemorrhagic stroke survivors, with hemorrhagic patients demonstrating superior recovery patterns.