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Location and severity of spasticity in the first 1–2 weeks and at 3 and 18 months after stroke
Author(s) -
Welmer A.K.,
Widén Holmqvist L.,
Sommerfeld D. K.
Publication year - 2010
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/j.1468-1331.2009.02915.x
Subject(s) - spasticity , clonus , medicine , modified ashworth scale , stroke (engine) , physical medicine and rehabilitation , physical therapy , psychiatry , mechanical engineering , engineering , epilepsy
Background and purpose: There is no consensus concerning the location or severity of spasticity, or how this changes with time after stroke. The purpose was to describe: the location and severity of spasticity, in different muscle groups, during the first 1–2 weeks and at 3 and 18 months after stroke; the association between the severity of spasticity and control of voluntary movements; and the occurrence of spasticity in younger versus older patients. Methods: In a cohort of consecutive patients, the following parameters were assessed during the first 1–2 weeks ( n = 109) and at 3 ( n = 95) and 18 ( n = 66) months after first‐ever stroke: spasticity, by the Modified Ashworth Scale in different muscle groups; plantar‐flexor clonus, by physical examination; and movement function, by the Lindmark Motor Assessment Scale. Results: During the first 1–2 weeks and at 3 months after stroke, spasticity was most common in the anti‐gravity muscles. The severity of upper extremity spasticity increased over time ( P < 0.05). Upper extremity spasticity and movement scores were moderately associated ( r = −0.61, P < 0.05). At 3 months, spasticity was more common amongst the younger patients ( P < 0.05). Conclusions: The results confirm that spasticity is most common in the anti‐gravity muscles and is associated with the control of voluntary movements. As the severity of spasticity also increased after 3 months, when neurally mediated spasticity is expected to have passed its peak, intrinsic muscle changes may play a larger role than neural components with the passage of time after stroke.