Early development of spasticity following stroke: a prospective, observational trial.
This study followed a cohort of 103 patients at median 6 days, 6 and 16 weeks after stroke and recorded muscle tone, pain, paresis, Barthel Index and quality of life score (EQ-5D) to identify risk-factors for development of spasticity. 24.5% of stroke victims developed an increase of muscle tone within 2 weeks after stroke. Patients with spasticity had significantly higher incidences of pain and nursing home placement and lower Barthel and EQ-5D scores than patients with normal muscle tone. Early predictive factors for presence of severe spasticity [modified Ashworth scale score (MAS) >or=3] at final follow-up were moderate increase in muscle tone at baseline and/or first follow-up (MAS = 2), low Barthel Index at baseline, hemispasticity, involvement of more than two joints at first follow-up, and paresis at any assessment point. The study helps to identify patients at highest risk for permanent and severe spasticity, and advocates for early treatment in this group.
Wissel
Jörg
J
Neurological Rehabilitation Hospital, Kliniken Beelitz GmbH, Paracelsusring 6a, Beelitz-Heilstätten, Germany. wissel@rehaklinik-beelitz.de
Schelosky
Ludwig D
LD
Scott
Jeffrey
J
Christe
Walter
W
Faiss
Jürgen H
JH
Mueller
Jörg
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D006801:Humans; D057187:Independent Living / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009128:Muscle Spasticity / Q000453:epidemiology* / Q000503:physiopathology*; D018482:Muscle, Skeletal / Q000294:innervation / Q000503:physiopathology*; D009735:Nursing Homes / Q000706:statistics & numerical data; D010146:Pain / Q000453:epidemiology; D011446:Prospective Studies; D020127:Recovery of Function / Q000502:physiology; D012307:Risk Factors; D012720:Severity of Illness Index; D020521:Stroke / Q000453:epidemiology* / Q000503:physiopathology*