Factors predictive of spasticity and their effects on motor recovery and functional outcomes in stroke patients

Top Stroke Rehabil. 2010 Sep-Oct;17(5):380-8. doi: 10.1310/tsr1705-380.

Abstract

Purpose: To determine the prevalence and factors predictive of spasticity in stroke patients transferred to a Department of Rehabilitation Medicine and to assess spasticity effects on motor recovery and functional outcomes.

Methods: A total of 245 patients consecutively admitted to the Department of Rehabilitation Medicine were evaluated. We examined spasticity prevalence and factors predictive of the condition. Spasticity was evaluated by the Modified Ashworth Scale (MAS).

Results: We found that 42.4% of stroke patients showed spasticity signs. Multivariate logistic regression analysis showed that National Institutes of Health Stroke Scale (NIHSS) scores, nonoperative treatment, and low Motricity Index scores were significantly predictive of spasticity after stroke. The total, motor, and cognitive FIMTM scores, and the FIMTM subscale scores assessed at admission, were similar in patients with and without spasticity. However, functional gains and eventual efficiency outcomes were greater for nonspastic patients.

Conclusions: The prevalence of spasticity in stroke patients transferred to our Department of Rehabilitation Medicine was 42.4%. NIHSS scores, nonoperative treatment, and low Motricity Index scores were significantly predictive of spasticity. A nonspastic group showed greater functional improvement during rehabilitation.

MeSH terms

  • Aged
  • Female
  • Humans
  • Logistic Models
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Motor Activity / physiology*
  • Muscle Spasticity / complications*
  • Muscle Spasticity / diagnosis
  • Muscle Spasticity / epidemiology*
  • Physical Therapy Modalities*
  • Predictive Value of Tests
  • Prevalence
  • Recovery of Function / physiology*
  • Reproducibility of Results
  • Retrospective Studies
  • Severity of Illness Index
  • Statistics, Nonparametric
  • Stroke Rehabilitation
  • Stroke* / complications
  • Stroke* / epidemiology
  • Tomography, X-Ray Computed