Early prediction of long-term upper limb spasticity after stroke: part of the SALGOT study.

  • Opheim A
  • Danielsson A
  • Alt Murphy M
 et al. 
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Abstract

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.

Author-supplied keywords

  • Aged
  • Early Diagnosis
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Muscle Spasticity
  • Muscle Spasticity: diagnosis
  • Muscle Spasticity: epidemiology
  • Muscle Spasticity: etiology
  • Predictive Value of Tests
  • Stroke
  • Stroke: complications
  • Stroke: diagnosis
  • Stroke: epidemiology
  • Sweden
  • Sweden: epidemiology
  • Time Factors
  • Treatment Outcome
  • Upper Extremity
  • Upper Extremity: pathology

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Authors

  • Arve Opheim

  • Anna Danielsson

  • Margit Alt Murphy

  • Hanna C Persson

  • Katharina Stibrant Sunnerhagen

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