title: Long-term three-stage rehabilitation intervention alleviates spasticity of the elbows, fingers, and plantar flexors and improves activities of daily living in ischemic stroke patients: a randomized, controlled trial.
abstract: To investigate the effects of rehabilitation interventions on spasticity and activities of daily living (ADL) in ischemic stroke patients. A total of 165 ischemic stroke patients were recruited and assigned randomly to a control group (CG, n=82) or a therapeutic group (TG, n=83). Rehabilitation interventions were performed in the TG. The Modified Ashworth Scale was used to evaluate the severity of spasticity in the fingers, elbows, and plantar flexors, and the Modified Barthel Index (MBI) was used to measure ADL performance. Evaluations were performed at baseline (M0) and at the end of the first, third, and sixth months (M1, M3, M6) after enrollment. At M0, 20.8% (16/77) in the CG and 29.9% (23/77) in the TG developed spasticity, whereas at M6, the incidence of spasticity increased to 36.4% (28/77) in the TG and 42.9% (33/77) of patients in the CG. Fewer patients developed spasticity in the fingers, elbows, and ankles in the TG than CG, respectively. Both groups showed significant improvements in MBI scores (M6 vs. M0, P<0.01). MBI scores correlated negatively with the severity of spasticity in both groups at M6. Long-term standardized rehabilitation interventions alleviate spasticity and promote ADL with the presence of minor spasticity (Supplementary video, Supplemental digital content 1, http://links.lww.com/WNR/A291).
authors.affiliation: aDepartment of Rehabilitation Medicine, Huashan Hospital bState Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, People's Republic of China.
authors.forename: Yu-Long
authors.initials: YL
authors.lastname: Bai
authors.forename: Yong-Shan
authors.initials: YS
authors.lastname: Hu
authors.forename: Yi
authors.initials: Y
authors.lastname: Wu
authors.forename: Yu-Lian
authors.initials: YL
authors.lastname: Zhu
authors.forename: Bei
authors.initials: B
authors.lastname: Zhang
authors.forename: Cong-Yu
authors.initials: CY
authors.lastname: Jiang
authors.forename: Li-Min
authors.initials: LM
authors.lastname: Sun
authors.forename: Wen-Ke
authors.initials: WK
authors.lastname: Fan
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D002545:Brain Ischemia / Q000150:complications / Q000503:physiopathology / Q000534:rehabilitation*; D004550:Elbow / Q000503:physiopathology*; D005260:Female; D005385:Fingers / Q000503:physiopathology*; D006801:Humans; D008297:Male; D009128:Muscle Spasticity / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D012720:Severity of Illness Index; D020521:Stroke / Q000150:complications / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D013997:Time Factors; D016896:Treatment Outcome