1	Flaccidity (immediately after onset): no voluntary movement initiated
2	Spasticity: basic synergy patterns appear, minimal voluntary movement possible
3	Voluntary control over synergies: with increase in spasticity
4	Some movement patterns out of synergy can be mastered: synergy still predominates, decrease in spasticity
5	If progress continues, more complex movement combinations can be learned as basic synergies lose their dominance: more decrease in spasticity can be seen
6	Spasticity disappears: more individual joint movements and normal coordination
7	Normal function is restored

Severity of UE weakness at onset (complete arm paralysis at onset has poor prognosis for recovery of useful hand function)

Timing of hand movement return (some motor recovery of hand by 4 weeks has 70% chance of making full/good recovery)

Poor prognosis: no measurable grasp by 4 weeks, severe proximal spasticity, prolonged flaccidity, late return of tapping response (facilitation)

Abnormal velocity-dependent resistance to passive movement of involved muscles at rest and posturing during ambulation or with noxious stimuli

Non-invasive	stretching
	splints, orthoses
	serial casting
	electrical stimulation
	cold modalities
Chemo- neurolysis	Botulinum toxin (useful in focal control of spasticity like at wrist and finger flexors or ankle invertors)
Chemo- neurolysis	Phenol/alcohol (rarely used, limited by adverse effects like pain with injection, post-injection dysesthesia/chronic pain)
Baclofen	Oral
Baclofen	Intrathecal baclofen pump: some evidence that with physical therapy it can help improve walking speed/functional mobility in post-stroke spastic hemiplegia
Surgery	may be useful in selected cases to improve function, hygiene, pain

Note: side effects of medications (baclofen, benzodiazepines, clonidine, tizanidine) usually limit their usefulness in stroke patients

Type	Description
Anomic	temporoparietal injury, angular gyrus; may also see alexia or agraphia
Conduction	injury to parietal operculum (arcuate fasciculus), insula or deep to supramarginal gyrus (usually left side); literal paraphasias, targeting of words
Transcortical sensory	watershed lesion isolating Broca’s/Wernicke’s areas from posterior brain, angular gyrus or posterior-inferior temporal lobe; echolalia, neologisms
Wernicke’s	posterior superior temporal gyrus of dominant (usually left) hemisphere; marked paraphasias, neologisms, alexia and agraphia
Transcortical motor	frontal lobe, anterior/superior to Broca’s area or in the subcortical area deep to Broca’s area; reduced rate, initiation, organization of speech
Broca’s	posterior-inferior frontal lobe of dominant (usually left) hemisphere; telegraphic speech, paraphasias, articulatory errors or struggling
Mixed transcortical	aka. isolation aphasia, lesions in borders of frontal, parietal, and temporal areas; decreased rate and initiation of speech, echolalia
Global	various sizes and locations but usually involves left MCA distribution; ranges from mutism to total repetitive jargon or neologistic output