Are clinical characteristics associated with upper-extremity hypertonia in severe ischaemic supratentorial stroke?

J Rehabil Med. 2007 Jan;39(1):33-7. doi: 10.2340/16501977-0009.


Objective: The primary goal of this study was to identify clinical risk factors, in addition to muscle weakness, for upper-extremity hypertonia in patients with severe ischaemic supratentorial stroke. The secondary goal was to investigate the time course of upper-extremity hypertonia in these patients during the first 26 weeks post-stroke.

Design: Inception cohort.

Patients: Forty-three consecutive patients with an acute ischaemic supratentorial stroke and an initial upper-extremity paralysis admitted to an academic hospital.

Primary outcome: hypertonia assessed by the Ashworth scale at week 26 post-stroke. Potential risks factors: motor functions assessed by the upper-extremity subscore of the Fugl-Meyer motor assessment, Barthel Index at week 1, consciousness, sensory disturbances, apraxia, neglect, and hyper-reflexia. Secondary outcome: time course of upper-extremity hypertonia by assessing its prevalence at 6 consecutive moments post-stroke during a follow-up period of 26 weeks.

Results: Twenty-five patients (63%) developed hypertonia during the follow-up period of 26 weeks. During this period, the prevalence of hypertonia followed a rather dynamic course, with cases of early, transient and late hypertonia. Univariate analyses yielded none of the selected clinical characteristics as significantly associated with hypertonia.

Conclusion: Despite the high incidence of hypertonia (63%) observed, none of the selected clinical characteristics could be identified as a risk factor for hypertonia.

MeSH terms

  • Aged
  • Arm / physiopathology*
  • Brain Ischemia / complications
  • Brain Ischemia / diagnosis
  • Brain Ischemia / physiopathology
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Motor Activity / physiology
  • Movement / physiology
  • Muscle Hypertonia / diagnosis
  • Muscle Hypertonia / etiology
  • Muscle Hypertonia / physiopathology*
  • Risk Factors
  • Stroke / complications
  • Stroke / diagnosis
  • Stroke / physiopathology*