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.
Neurological Rehabilitation Hospital, Kliniken Beelitz GmbH, Paracelsusring 6a, Beelitz-Heilstätten, Germany. wissel@rehaklinik-beelitz.de
Jörg
J
Wissel
Ludwig D
LD
Schelosky
Jeffrey
J
Scott
Walter
W
Christe
Jürgen H
JH
Faiss
Jörg
J
Mueller
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*