Three longitudfinal studies have reported that the development of elbow and wrist contractures could be predicted by baseline measures of weakness, spasticity and upper limb function (Ada et al 2006, Malhotra et al 2011, Pandyan et al 2003). However these studies were small (n ≤ 30 in all three studies), did not examine multivariate predictors (Malhotra et al 2011, Pandyan et 2003), and considered few potential predictors (Ada et al 2006, Malhotra et al 2011, Pandyan et al 2003). The research questions

for this study were: 1. What is the incidence of contractures six months after stroke? What is already known on this topic: Contractures are common after stroke. They can Crizotinib ic50 limit functional performance and cause

complications such as pain, pressure ulcers, and falls. What this study adds: Within six months after stroke, about half of all patients develop NLG919 a contracture. Muscle strength is a significant predictor of elbow, wrist, and ankle contractures but cannot be used to accurately predict contractures in these joints. Simple clinical measures do not accurately predict who will develop a contracture. A prospective inception cohort study was conducted. Consecutive patients admitted to the accident and emergency department of St George Hospital (from January 2009 to January 2010) with a diagnosis of stroke or transient ischemic attack were screened. St George Hospital is a large teaching hospital that serves residents of southern Sydney, Australia, and admits more than 500 patients a year with stroke and transient ischaemic attacks (SESIAHS 2010). Participants were folflowed up six months after stroke. Patients

were eligible for inclusion Thiamine-diphosphate kinase if they were over 18 years old, had a medically documented stroke (WHO 1988), were able to respond to basic commands, and understood English. Patients who received recombinant tissue plasminogen activator were included if they had persisting neurological symptoms 24 hours after receiving treatment. Patients with subarachnoid haemorrhages were included only if they had neurological symptoms consistent with the WHO definition of stroke (WHO 1988). Consent was sought from patients or, where patients were unable to consent, from guardians. All patients received standard medical and allied health care. Although no attempt at standardisation was made, care was generally administered in a way that was broadly consistent with the recommendation of the National Stroke Foundation guidelines (National Stroke Foundation, 2010a and National Stroke Foundation, 2010b). Three physiotherapists collected the data. Joint range of motion was measured as soon as possible (within four weeks) and six months folflowing stroke. All measurements were performed with the participants either in supine or sitting. The folflowing procedures were used.