Predicting spasticity after stroke in those surviving to 12 months.
OBJECTIVE
To measure muscle tone in a cohort of patients 12 months after stroke and develop a preliminary model, using data recorded routinely after stroke, to predict who will develop spasticity.


METHODS
A cohort study.


METHODS
Initially hospitalized but subsequently community-dwelling stroke survivors in Liverpool, United Kingdom.


METHODS
One hundred and six consecutively presenting stroke patients surviving to 12 months.


METHODS
Spasticity measured at a range of joints using the Tone Assessment Scale.


RESULTS
The Tone Assessment Scale revealed spasticity in 38 (36%) patients and more severe spasticity in 21 (20%) of the 106 patients. Logistic regression analysis revealed that lower day 7 Barthel Index score and early arm or leg weakness were significant predictors of abnormal muscle tone; and lower day 7 Barthel Index score, left-sided weakness and ever smoked to be significant predictors of more severe muscle tone.


CONCLUSIONS
Using the models, it may be possible to predict whether or not spasticity will develop in patients 12 months after stroke. The utility of the models is aided by their use of predictor variables that are routinely collected as part of stroke care in hospital and which are easy to measure. The models need testing prospectively in a new cohort of patients in order to test their validity, reliability and utility and to determine if other data could improve their efficiency.
Leathley
M J
MJ
Stroke Team for Audit and Research, University Hospital Aintree, Liverpool, UK. mjleathley@uclan.ac.uk
Gregson
J M
JM
Moore
A P
AP
Smith
T L
TL
Sharma
A K
AK
Watkins
C L
CL
D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D009128:Muscle Spasticity / Q000209:etiology*; D011379:Prognosis; D013223:Statistics as Topic; D020521:Stroke / Q000150:complications*; D017741:Survivors