title: The negative impact of spasticity on the health-related quality of life of stroke survivors: a longitudinal cohort study.
abstract: BACKGROUND
  Spasticity often leads to symptomatic and functional problems that can cause disability for stroke survivors. We studied whether spasticity has a negative impact on health-related quality of life (HRQoL).
  
  
  METHODS
  As part of the Greater Cincinnati/Northern Kentucky Stroke Study (NCT00642213), 460 ischemic stroke patients were interviewed during hospitalization and then followed over time. HRQoL was measured by the Physical Component Summary (PCS) and Mental Component Summary (MCS) scores of the Short Form-12 (SF-12), EuroQol-5 dimension (EQ-5D), and Stroke-Specific Quality of Life (SSQOL) instruments, with lower scores indicating worse health. HRQoL differences between stroke survivors with and without spasticity were compared, adjusting for age, race, stroke severity, pre-stroke function, and comorbidities.
  
  
  RESULTS
  Of the 460 ischemic stroke patients, 328 had spasticity data available 3 months after their stroke (mean age of 66 years, 49% were female, and 26% were black). Of these patients, 54 (16%) reported having spasticity. Three months following their stroke, patients who reported spasticity had lower mean scores on the PCS (29.6 ± 1.4 vs 37.3 ± 0.6; P < .001), EQ-5D (0.59 ± 0.03 vs 0.71 ± 0.01; P < .001), and SSQOL (3.57 ± 0.08 versus 3.78 ± 0.03; P = .03) compared with patients who did not report spasticity. Lower HRQoL scores were also observed at the 1-year (PCS, EQ-5D, and SSQOL) and 2-year (EQ-5D and SSQOL) interviews in those with spasticity compared with those without spasticity.
  
  
  CONCLUSIONS
  Statistically and clinically meaningful differences in HRQoL exist between stroke survivors with and without spasticity.
authors.affiliation: Department of Global Health Outcomes Strategy and Research, Allergan, Inc., 2525 Dupont Drive, Irvine, California, 92612-1531, USA. gillard_patrick@allergan.com.
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Gillard
authors.affiliation: Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC 5041, Cincinnati, OH, 45229-3039, USA. Heidi.Sucharew@cchmc.org.
authors.forename: Heidi
authors.initials: H
authors.lastname: Sucharew
authors.affiliation: Department of Neurology and Rehabilitation Medicine, University of Cincinnati, 260 Stetson St., Suite 2300, PO Box 670525, Cincinnati, OH, 45267-0525, USA. KLEINDDO@UCMAIL.UC.EDU.
authors.forename: Dawn
authors.initials: D
authors.lastname: Kleindorfer
authors.affiliation: Departments of Neurology and Rehabilitation Medicine, Emory University School of Medicine, Faculty Office Building, Rm# 375, 80 Jesse Hill Jr Dr. SE, Atlanta, GA, 30303, USA. samir.r.belagaje@emory.edu.
authors.forename: Samir
authors.initials: S
authors.lastname: Belagaje
authors.affiliation: Department of Global Health Outcomes Strategy and Research, Allergan, Inc., 2525 Dupont Drive, Irvine, California, 92612-1531, USA. Varon_Sepideh@Allergan.com.
authors.forename: Sepideh
authors.initials: S
authors.lastname: Varon
authors.affiliation: Department of Neurology and Rehabilitation Medicine, University of Cincinnati, 260 Stetson St., Suite 2300, PO Box 670525, Cincinnati, OH, 45267-0525, USA. alwellkn@ucmail.uc.edu.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Alwell
authors.affiliation: Department of Neurology and Rehabilitation Medicine, University of Cincinnati, 260 Stetson St., Suite 2300, PO Box 670525, Cincinnati, OH, 45267-0525, USA. Charles.Moomaw@uc.edu.
authors.forename: Charles J
authors.initials: CJ
authors.lastname: Moomaw
authors.affiliation: Department of Neurology and Rehabilitation Medicine, University of Cincinnati, Division of Neurocritical Care, University of Cincinnati, 231 Albert Sabin Way, ML 0769, Cincinnati, OH, 45267, USA. WOODL@UCMAIL.UC.EDU.
authors.forename: Daniel
authors.initials: D
authors.lastname: Woo
authors.affiliation: Department of Neurology and Rehabilitation Medicine, University of Cincinnati, 260 Stetson St., Suite 2300, PO Box 670525, Cincinnati, OH, 45267-0525, USA. khatrip@UCMAIL.UC.EDU.
authors.forename: Pooja
authors.initials: P
authors.lastname: Khatri
authors.affiliation: Department of Neurology and Rehabilitation Medicine, University of Cincinnati, 260 Stetson St., Suite 2300, PO Box 670525, Cincinnati, OH, 45267-0525, USA. flaherm@UCMAIL.UC.EDU.
authors.forename: Matthew L
authors.initials: ML
authors.lastname: Flaherty
authors.affiliation: Department of Emergency Medicine and Neurosurgery, University of Cincinnati, 231 Albert Sabin Way, ML 0769, Cincinnati, OH, 45267, USA. adeoyeo@UCMAIL.UC.EDU.
authors.forename: Opeolu
authors.initials: O
authors.lastname: Adeoye
authors.affiliation: Department of Neurology and Rehabilitation Medicine, University of Cincinnati, 260 Stetson St., Suite 2300, PO Box 670525, Cincinnati, OH, 45267-0525, USA. simona.ferioli@uc.edu.
authors.forename: Simona
authors.initials: S
authors.lastname: Ferioli
authors.affiliation: Department of Neurology and Rehabilitation Medicine, University of Cincinnati, University Hospital Medical Arts Building, 222 Piedmont Avenue, Suite 3200, Cincinnati, OH, 45219, USA. Brett.kissela@uc.edu.
authors.forename: Brett
authors.initials: B
authors.lastname: Kissela
mesh_terms: D000368:Aged; D015331:Cohort Studies; D015897:Comorbidity; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009128:Muscle Spasticity / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D063868:Patient Outcome Assessment; D011788:Quality of Life / Q000523:psychology*; D020521:Stroke / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy*; D017741:Survivors / Q000523:psychology / Q000706:statistics & numerical data*