Early development of spasticity following stroke: a prospective, observational trial

J Neurol. 2010 Jul;257(7):1067-72. doi: 10.1007/s00415-010-5463-1. Epub 2010 Feb 6.


This study followed a cohort of 103 patients at median 6 days, 6 and 16 weeks after stroke and recorded muscle tone, pain, paresis, Barthel Index and quality of life score (EQ-5D) to identify risk-factors for development of spasticity. 24.5% of stroke victims developed an increase of muscle tone within 2 weeks after stroke. Patients with spasticity had significantly higher incidences of pain and nursing home placement and lower Barthel and EQ-5D scores than patients with normal muscle tone. Early predictive factors for presence of severe spasticity [modified Ashworth scale score (MAS) >or=3] at final follow-up were moderate increase in muscle tone at baseline and/or first follow-up (MAS = 2), low Barthel Index at baseline, hemispasticity, involvement of more than two joints at first follow-up, and paresis at any assessment point. The study helps to identify patients at highest risk for permanent and severe spasticity, and advocates for early treatment in this group.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cohort Studies
  • Comorbidity
  • Female
  • Humans
  • Independent Living / statistics & numerical data
  • Male
  • Middle Aged
  • Muscle Spasticity / epidemiology*
  • Muscle Spasticity / physiopathology*
  • Muscle, Skeletal / innervation
  • Muscle, Skeletal / physiopathology*
  • Nursing Homes / statistics & numerical data
  • Pain / epidemiology
  • Prospective Studies
  • Recovery of Function / physiology
  • Risk Factors
  • Severity of Illness Index
  • Stroke / epidemiology*
  • Stroke / physiopathology*