PT  - JOURNAL ARTICLE
AU  - Opheim, Arve
AU  - Danielsson, Anna
AU  - Alt Murphy, Margit
AU  - Persson, Hanna C.
AU  - Sunnerhagen, Katharina Stibrant
TI  - Early prediction of long-term upper limb spasticity after stroke
AID  - 10.1212/WNL.0000000000001908
DP  - 2015 Sep 08
TA  - Neurology
PG  - 873--880
VI  - 85
IP  - 10
4099  - http://n.neurology.org/content/85/10/873.short
4100  - http://n.neurology.org/content/85/10/873.full
SO  - Neurology2015 Sep 08; 85
AB  - Objective: To identify predictors and the optimal time point for the early prediction of the presence and severity of spasticity in the upper limb 12 months poststroke.Methods: In total, 117 patients in the Gothenburg area who had experienced a stroke for the first time and with documented arm paresis day 3 poststroke were consecutively included. Assessments were made at admission and at 3 and 10 days, 4 weeks, and 12 months poststroke. Upper limb spasticity in elbow flexion/extension and wrist flexion/extension was assessed with the modified Ashworth Scale (MAS). Any spasticity was regarded as MAS ≥1, and severe spasticity was regarded as MAS ≥2 in any of the muscles. Sensorimotor function, sensation, pain, and joint range of motion in the upper limb were assessed with the Fugl-Meyer assessment scale, and, together with demographic and diagnostic information, were included in both univariate and multivariate logistic regression analysis models. Seventy-six patients were included in the logistic regression analysis.Results: Sensorimotor function was the most important predictor both for any and severe spasticity 12 months poststroke. In addition, spasticity 4 weeks poststroke was a significant predictor for severe spasticity. The best prediction model for any spasticity was observed 10 days poststroke (85% sensitivity, 90% specificity). The best prediction model for severe spasticity was observed 4 weeks poststroke (91% sensitivity, 92% specificity).Conclusions: Reduced sensorimotor function was the most important predictor both for any and severe spasticity, and spasticity could be predicted with high sensitivity and specificity 10 days poststroke.ADL=activities of daily living; ARAT=Action Research Arm Test; CI=confidence interval; FMA-UE=Fugl-Meyer Assessment Upper Extremity Scale; MAS=modified Ashworth Scale; NIHSS=NIH Stroke Scale; NLR=negative likelihood ratio; PLR=positive likelihood ratio; ROM=range of motion; SALGOT=Stroke Arm Longitudinal Study at the University of Gothenburg