Symptomatic upper limb spasticity in patients with chronic stroke attending a rehabilitation clinic: frequency, clinical correlates and predictors.

Abstract

Objective: To document the frequency, clinical correlates and predictors of symptomatic upper limb spasticity in patients one year or more after stroke. Design: Cross-sectional study. Subjects: A total of 140 patients after stroke attending a rehabilitation clinic. Methods: Assessments of spasticity, upper limb function and self-care ability using the Ashworth Scale (AS), Motor Assessment Scale and Modified Barthel Index. We categorized spasticity as: spasticity in general (AS score ?1), severe spasticity (AS score ?3) and symptomatic spasticity (spasticity affecting upper limb function). Results: The mean age (standard deviation, SD) was 61. 0 (SD 13. 3) years and patients were evaluated at 41. 7 (SD 35. 1) months after stroke onset. The observed frequency of spasticity in general, severe spasticity and symptomatic spasticity was 78. 6%, 38. 6% and 30%, respectively. The total AS score was the most important correlate of symptomatic spasticity; patients with higher scores were likely to be symptomatic (p?=?0. 001). Severe spasticity was predicted by poor lower extremity power (p?=?0. 002), high National Institute of Health Stroke Scale score (p?=?0. 015) and presence of dysphasia (p?=?0. 046) on admission to rehabilitation. No predictors of symptomatic spasticity could be established. Conclusion: Symptomatic spasticity is relatively common in patients with chronic stroke and is significantly correlated with the severity of spasticity.