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PREP stands for Predicting REcovery Potential for the hand and arm.

PREP is a 3 stage test for patients who have had a stroke. The test results help predict the potential to recover arm and hand movement. This means that clinicians and patients can set suitable rehabilitation goals and better customise therapy to achieve the patient's full potential.






PREP is currently being used in a research context. We hope that by establishing the evidence for this tool, clinicians and patients will be able to use it to reduce uncertainty about recovery after stroke.

PREP needs to start within 3 days of the stroke.

PREP requires 3 simple steps. Most people will only need the first step.


Step 1: Standardised arm movements scored by clinicians
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Step 2: Testing the motor pathways to the affected arm (Transcranial magnetic stimulation)
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Step 3: Detailed imaging of the brain (MRI Scan)
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Not all steps have to be completed for every patient in order to make a prediction. A prediction can be made for around half of patients using just the first step. The tests are started within the first three days after stroke and can help tell us how well the patient's hand and arm are expected to work at 12 weeks after stroke. Refer to further details of the steps here.

What are the benefits of PREP?

The key purpose for developing PREP is to aid the stroke rehabilitation process by:
  • Identifying patients with potential for recovery that might otherwise go unrecognised
  • Setting individual rehabilitation goals and plans
  • Managing the expectations of patients, their families, and health professionals

PREP is an efficient and economical system. It starts with bedside clinical assessment and moves on to more complex assessments for only some patients, to distinguish between those with limited or essentially no potential for recovery. It also ensures that time and effort spent on rehabilitation is tailored to the patient's likely level of recovery.

The PREP algorithm can also be used for stratification in clinical trials by identifying patients that are more or less likely to respond to new upper limb therapies.


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