DK Sommerfeld, Elsy UB Eek, AK Svensson, LW Holmqvist, MH von Arbin
Spasticity affects less than one quarter of stroke victims, according to this study.
Muscle overactivity and its consequences were assessed in 95 patients both immediately after and three months a first-time stroke. Seventy-seven (81%) were initially hemiparetic, of whom 20 had spasticity. Among these 20 patients, 14 had hyperreflexia. Within these patients, 3 had clonus, and 3 had muscle stiffness. Modified Ashworth score was grade 1 in 10 patients, grade 1+ in 7, and grade 2 in 3. None had grades of 3 or 4. At three months, 64 patients (67%) were hemiparetic, and 18 spastic, reflecting 5 whose tone normalized and 3 who became spastic in the interim. The correlation between muscle tone and a range of motor and activity scores was low for most measures at both time points, except for active movements initially, and rapid movement scores and 9-Hole Peg Test scores at three months.
The authors conclude, “spasticity seems to contribute to motor impairments and activity limitations and may be a severe problem for some patients after stroke,” but, given the relatively low numbers of patients with spasticity, they note, “Our findings support the opinion.that the focus on spasticity in stroke rehabilitation is out of step with its clinical importance. Careful and continual evaluation to establish the causes of a patient’s disabilities is essential before a decision is made on the most proper rehabilitation approach.”
Copyright 2003 WE MOVE