Vol 53, No 6 (2019)
Research paper
Published online: 2019-12-17
Submitted: 2019-09-12
Accepted: 2019-12-06
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Prevalence and predictors of post-stroke spasticity and its impact on daily living and quality of life

Michał J. Schinwelski, Emilia J. Sitek, Piotr Wąż, Jarosław W. Sławek
DOI: 10.5603/PJNNS.a2019.0067
·
Pubmed: 31845749
·
Neurol Neurochir Pol 2019;53(6):449-457.

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Vol 53, No 6 (2019)
Research paper
Published online: 2019-12-17
Submitted: 2019-09-12
Accepted: 2019-12-06

Abstract

Background and aims. The present study aimed to assess the frequency of spasticity in a single-centre cohort of stroke patients in a one-year follow-up, its predictors, and its impact on the activities of daily living (ADL) and health-related quality of life (HRQoL).

Material and methods. A group of 121 consecutive patients with hemiparesis (aged 73 ± 11 years) was selected for further observation, out of 381 Stroke Department patients during one year. At three follow-up assessments three, six and 12 months after stroke, muscle tone and muscle weakness were rated using Modified Ashworth Scale (MAS) and Medical Research Council (MRC); Activities of Daily Living (ADL) and Health Related Quality of Life (HRQoL) were evaluated using the Barthel Index (BI), Modified Rankin Scale (mRS) and an SF-36 questionnaire.

Results. Fifty five of 121 (45%) patients after three months had developed spasticity (MAS ≥ 1), and in 19 of the 121 (15%) this spasticity was severe. After one year, 33/94 (35%) patients showed spasticity, and in 19/94 (20%) it was severe. Baseline muscle weakness (MRC), stroke severity as measured by the National Institutes of Health Stroke Scale (NIHSS), and greater disability (BI), were the most significant predictors of persistent post-stroke spasticity. Patients with spasticity had worse HRQoL in terms of their physical functioning, role limitations, physical pain, and vitality.

Conclusion. Spasticity, which affects a significant proportion of stroke survivors, was present in 35% of our patients at 12 months after stroke. It has a major impact on both ADL and HRQoL. Severe disability and muscle weakness are the most important predictors of persistent post-stroke spasticity.

Abstract

Background and aims. The present study aimed to assess the frequency of spasticity in a single-centre cohort of stroke patients in a one-year follow-up, its predictors, and its impact on the activities of daily living (ADL) and health-related quality of life (HRQoL).

Material and methods. A group of 121 consecutive patients with hemiparesis (aged 73 ± 11 years) was selected for further observation, out of 381 Stroke Department patients during one year. At three follow-up assessments three, six and 12 months after stroke, muscle tone and muscle weakness were rated using Modified Ashworth Scale (MAS) and Medical Research Council (MRC); Activities of Daily Living (ADL) and Health Related Quality of Life (HRQoL) were evaluated using the Barthel Index (BI), Modified Rankin Scale (mRS) and an SF-36 questionnaire.

Results. Fifty five of 121 (45%) patients after three months had developed spasticity (MAS ≥ 1), and in 19 of the 121 (15%) this spasticity was severe. After one year, 33/94 (35%) patients showed spasticity, and in 19/94 (20%) it was severe. Baseline muscle weakness (MRC), stroke severity as measured by the National Institutes of Health Stroke Scale (NIHSS), and greater disability (BI), were the most significant predictors of persistent post-stroke spasticity. Patients with spasticity had worse HRQoL in terms of their physical functioning, role limitations, physical pain, and vitality.

Conclusion. Spasticity, which affects a significant proportion of stroke survivors, was present in 35% of our patients at 12 months after stroke. It has a major impact on both ADL and HRQoL. Severe disability and muscle weakness are the most important predictors of persistent post-stroke spasticity.

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Keywords

spasticity, stroke, epidemiology, quality of life, predictors, hemiplegia

About this article
Title

Prevalence and predictors of post-stroke spasticity and its impact on daily living and quality of life

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 53, No 6 (2019)

Pages

449-457

Published online

2019-12-17

DOI

10.5603/PJNNS.a2019.0067

Pubmed

31845749

Bibliographic record

Neurol Neurochir Pol 2019;53(6):449-457.

Keywords

spasticity
stroke
epidemiology
quality of life
predictors
hemiplegia

Authors

Michał J. Schinwelski
Emilia J. Sitek
Piotr Wąż
Jarosław W. Sławek

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