Predicting motor recovery using surface electromyography in people with severe motor impairment after stroke: A prospective cohort study protocol.

Stroke is a leading cause of long-term disability, resulting in motor impairments that significantly affect the quality of life. Predicting motor recovery is particularly difficult for people with severe motor impairment early after stroke. Traditional assessments are limited in terms of residual muscle activity, which is crucial for tailoring rehabilitation interventions. Incorporating surface electromyography (sEMG) assessment can provide a deeper understanding of motor recovery potential in severe motor impairment. This prospective cohort study aims to develop a TRIPOD-compliant prediction model to examine whether sEMG amplitude recorded from five upper and four lower extremity muscles within the first week of stroke could predict motor recovery at 3 months post-stroke. This prospective study will include 76 participants between the ages of 18-80 years presenting first-ever anterior or middle cerebral artery stroke resulting in a severe motor impairment within the first week of stroke onset. In addition to sEMG recording to evaluate muscle activity, participants will undergo a comprehensive clinical assessment of motor functions and activity at the 1st and 3rd months following stroke onset. Multivariate regression analyses will be used to determine associations between sEMG metrics and recovery outcomes.