title: Poststroke chronic disease management: towards improved identification and interventions for poststroke spasticity-related complications.
abstract: This paper represents the opinion of a group of researchers and clinicians with an established interest in poststroke care and is based on the recognised need for long-term care following stroke, especially in view of the global increase of disability due to stroke. Among the more frequent long-term complications following stroke are spasticity-related disabilities. Although spasticity alone occurs in up to 60% of stroke survivors, disabling spasticity affects only 4-10%. Spasticity further interferes with important functions of daily life when it occurs in association with pain, motor impairment, and overall declines of cognitive and neurological function. It is proposed that the aftermath of stroke be considered a chronic disease requiring a multifactorial and multilevel approach. There are, however, knowledge gaps related to the prediction and recognition of poststroke disability. Interventions to prevent or minimise such disabilities require further development and evaluation. Poststroke spasticity research should focus on reducing disability and be considered as part of a continuum of chronic care requirements and should be recognised as a part of a comprehensive poststroke disease management programme.
authors.affiliation: Department of Clinical Medicine and Prevention and Center for Clinical Neurosciences, Danube University Krems, Krems, Austria. michael.brainin@donau-uni.ac.at
authors.forename: Michael
authors.initials: M
authors.lastname: Brainin
authors.forename: Bo
authors.initials: B
authors.lastname: Norrving
authors.forename: Katharina S
authors.initials: KS
authors.lastname: Sunnerhagen
authors.forename: Larry B
authors.initials: LB
authors.lastname: Goldstein
authors.forename: Steven C
authors.initials: SC
authors.lastname: Cramer
authors.forename: Geoffrey A
authors.initials: GA
authors.lastname: Donnan
authors.forename: Pamela W
authors.initials: PW
authors.lastname: Duncan
authors.forename: Gerard
authors.initials: G
authors.lastname: Francisco
authors.forename: David
authors.initials: D
authors.lastname: Good
authors.forename: Glenn
authors.initials: G
authors.lastname: Graham
authors.forename: Brett M
authors.initials: BM
authors.lastname: Kissela
authors.forename: John
authors.initials: J
authors.lastname: Olver
authors.forename: Anthony
authors.initials: A
authors.lastname: Ward
authors.forename: Jörg
authors.initials: J
authors.lastname: Wissel
authors.forename: Richard
authors.initials: R
authors.lastname: Zorowitz
mesh_terms: D019468:Disease Management; D006801:Humans; D009128:Muscle Spasticity / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy*; D020521:Stroke / Q000150:complications* / Q000628:therapy*; D016896:Treatment Outcome