Document Detail

Occurrence and temporal evolution of upper limb spasticity in stroke patients admitted to a rehabilitation unit.
MedLine Citation:
PMID:  22200394     Owner:  NLM     Status:  In-Data-Review    
OBJECTIVES: To document the temporal development and evolution of upper limb spasticity, and to establish clinical correlates and predictors of upper limb spasticity in a cohort of stroke patients.
DESIGN: Prospective cohort study.
SETTING: A rehabilitation unit.
PARTICIPANTS: Patients (N=163) with a first-ever ischemic stroke.
INTERVENTIONS: Not applicable.
MAIN OUTCOME MEASURES: Ashworth Scale for measuring upper limb spasticity, Motor Assessment Scale for upper limb activity, Motricity Index for upper limb strength, and Modified Barthel Index for self-care. Upper limb spasticity was defined as an Ashworth Scale score of 1 or greater.
RESULTS: Upper limb spasticity occurred in 54 patients (33%) at 3 months after stroke. Development of spasticity at later stages of the stroke was infrequent, occurring in only 28 patients (17%). In patients with mild spasticity (Ashworth Scale score 1) at 3 months after stroke, worsening of spasticity occurred in only 1 patient. On the other hand, almost half of the patients with moderate spasticity (Ashworth Scale score 2) at 3 months progressed to severe spasticity (Ashworth Scale score 3). Poor upper limb activity was the most important correlate of "moderate to severe spasticity" (Ashworth Scale score ≥2) (P<.001), and poor upper limb strength on admission to rehabilitation, the most important predictor of "moderate to severe spasticity" (P<.001).
CONCLUSIONS: Upper limb spasticity was relatively infrequent in this study, occurring in 33% of patients at 3 months after stroke. Selective monitoring to detect severe spasticity is recommended for patients with an Ashworth Scale score of 2 or greater at 3 months after stroke, and in patients with severe upper limb weakness on admission to rehabilitation.
Keng H Kong; Jeanette Lee; Karen S Chua
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Archives of physical medicine and rehabilitation     Volume:  93     ISSN:  1532-821X     ISO Abbreviation:  Arch Phys Med Rehabil     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2011-12-27     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  2985158R     Medline TA:  Arch Phys Med Rehabil     Country:  United States    
Other Details:
Languages:  eng     Pagination:  143-8     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
Department of Rehabilitation Medicine, Tan Tock Seng Hospital, Singapore.
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