RT Journal Article
SR Electronic
T1 Early prediction of long-term upper limb spasticity after stroke
JF Neurology
JO Neurology
FD Lippincott Williams & Wilkins
SP 873
OP 880
DO 10.1212/WNL.0000000000001908
VO 85
IS 10
A1 Opheim, Arve
A1 Danielsson, Anna
A1 Alt Murphy, Margit
A1 Persson, Hanna C.
A1 Sunnerhagen, Katharina Stibrant
YR 2015
UL http://n.neurology.org/content/85/10/873.abstract
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