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Post‐stroke Spasticity: Predictors of Early Development and Considerations for Therapeutic Intervention
Author(s) -
Wissel Jörg,
Verrier Molly,
Simpson David M.,
Charles David,
Guinto Pia,
Papapetropoulos Spyros,
Sunnerhagen Katharina S.
Publication year - 2015
Publication title -
pmandr
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.617
H-Index - 66
eISSN - 1934-1563
pISSN - 1934-1482
DOI - 10.1016/j.pmrj.2014.08.946
Subject(s) - spasticity , medicine , stroke (engine) , physical medicine and rehabilitation , rehabilitation , intervention (counseling) , paresis , physical therapy , muscle tone , surgery , psychiatry , mechanical engineering , engineering
Objective The complexities of post‐stroke spasticity (PSS), and the resultant difficulties in treating the disability, present a significant challenge to patients, stroke rehabilitation teams, and caregivers. Reducing the severity of spasticity and its long‐term complications may be facilitated by early intervention, making identification of stroke patients at high risk for developing spasticity essential. Factors that predict which patients are at risk for the development of PSS are identified. Type Systematic search and review Literature Survey A PubMed search of the following terms was conducted: predictors OR risk factors AND stroke AND spasticity. Studies discussing predictors of early PSS development and factors predictive of motor/functional outcomes and recovery were selected and reviewed in detail. Synthesis Several predictors of PSS have been proposed, based on studies conducted in patients within 6 months after stroke, including development of increased muscle tone, greater severity of paresis, hemihypesthesia, and low Barthel Index score. Predictors identified in later stages post‐stroke (within 12 months) have also proved useful for clinicians, as has the consideration of predictors of motor and functional outcomes and recovery; yet there is a need for additional studies in this area. An understanding of these and other potential predictive factors—such as motor impairment, neurologic and sensory deficit, lesion volume and location, and associated diseases—has not progressed to the same extent and warrants further investigation. Conclusion The studies discussed in this review support the notion that early identification of factors predictive of PSS should significantly affect the course of intervention, help target individuals who would benefit most from specific types and intensities of therapy, and possibly provide better motor and functional outcomes.