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In this study, we present the results from one of the first meta-analyses of the involvement of the FMK in acute ischemic stroke. These results have important implications for healthcare providers dealing with patients with strokes.
Our findings show that the involvement of the FMK is not a strong determinant of stroke recurrence in the long term. Nevertheless, the involvement of the FMK is one of the strongest predictors for poor recovery of motor function. This emphasizes the importance of neurophysiologic testing to predict outcome. If the FMK is involved, motor function recovery will be extremely poor. The prognosis for patients with acute ischemic stroke with vascular etiology in which the FMK is involved will not change after referral to a tertiary center.
Since the degree of the involvement of the FMK was not associated with stroke recurrence, it is not possible to distinguish between the duration or severity of symptoms. Also, it has been shown that changes in valsalva maneuvers are seen in patients with other diseases besides cerebrovascular disease^[@bib29]^ so it would not be possible to tell whether the recurrence of stroke was due to the underlying vascular disease or the kinesiological process itself.
Our study provides important insights into the nature of the association between the involvement of the FMK and poor motor function recovery after acute ischemic stroke. The reported fMRI, transcranial magnetic stimulation studies and diffusion tensor imaging