Michał J Schinwelski1,2,3, Emilia J Sitek4,5, Piotr Wąż6, Jarosław W Sławek4,5. 1. Neurology Department, St. Adalbert Hospital, Copernicus, Aleja Jana Pawła II 50, 80-462 Gdańsk, Poland. szyna777@gmail.com. 2. Neurological and Psychiatric Nursing Department, Faculty of Health Sciences, Medical University of Gdansk, Dębinki 7, 80-211 Gdańsk, Poland. szyna777@gmail.com. 3. Specjalistyczny Gabinet Lekarski Poradnia Neurologiczna Michał Schinwelski, Kościuszki 12, 83-110 Tczew, Poland. szyna777@gmail.com. 4. Neurology Department, St. Adalbert Hospital, Copernicus, Aleja Jana Pawła II 50, 80-462 Gdańsk, Poland. 5. Neurological and Psychiatric Nursing Department, Faculty of Health Sciences, Medical University of Gdansk, Dębinki 7, 80-211 Gdańsk, Poland. 6. Department of Nuclear Medicine, Faculty of Health Sciences, Medical University of Gdańsk, Tuwima 15, 80-211 Gdańsk, Poland.
Abstract
BACKGROUND AND AIMS: The present study aimed to assess the frequency of spasticity in a single-centre cohort of stroke patients in a one-year follow-up, its predictors, and its impact on the activities of daily living (ADL) and health-related quality of life (HRQoL). MATERIAL AND METHODS: A group of 121 consecutive patients with hemiparesis (aged 73 ± 11 years) was selected for further observation, out of 381 Stroke Department patients during one year. At three follow-up assessments three, six and 12 months after stroke, muscle tone and muscle weakness were rated using Modified Ashworth Scale (MAS) and Medical Research Council (MRC); Activities of Daily Living (ADL) and Health Related Quality of Life (HRQoL) were evaluated using the Barthel Index (BI), Modified Rankin Scale (mRS) and an SF-36 questionnaire. RESULTS: Fifty five of 121 (45%) patients after three months had developed spasticity (MAS ≥ 1), and in 19 of the 121 (15%) this spasticity was severe. After one year, 33/94 (35%) patients showed spasticity, and in 19/94 (20%) it was severe. Baseline muscle weakness (MRC), stroke severity as measured by the National Institutes of Health Stroke Scale (NIHSS), and greater disability (BI), were the most significant predictors of persistent post-stroke spasticity. Patients with spasticity had worse HRQoL in terms of their physical functioning, role limitations, physical pain, and vitality. CONCLUSION: Spasticity, which affects a significant proportion of stroke survivors, was present in 35% of our patients at 12 months after stroke. It has a major impact on both ADL and HRQoL. Severe disability and muscle weakness are the most important predictors of persistent post-stroke spasticity.
BACKGROUND AND AIMS: The present study aimed to assess the frequency of spasticity in a single-centre cohort of strokepatients in a one-year follow-up, its predictors, and its impact on the activities of daily living (ADL) and health-related quality of life (HRQoL). MATERIAL AND METHODS: A group of 121 consecutive patients with hemiparesis (aged 73 ± 11 years) was selected for further observation, out of 381 Stroke Department patients during one year. At three follow-up assessments three, six and 12 months after stroke, muscle tone and muscle weakness were rated using Modified Ashworth Scale (MAS) and Medical Research Council (MRC); Activities of Daily Living (ADL) and Health Related Quality of Life (HRQoL) were evaluated using the Barthel Index (BI), Modified Rankin Scale (mRS) and an SF-36 questionnaire. RESULTS: Fifty five of 121 (45%) patients after three months had developed spasticity (MAS ≥ 1), and in 19 of the 121 (15%) this spasticity was severe. After one year, 33/94 (35%) patients showed spasticity, and in 19/94 (20%) it was severe. Baseline muscle weakness (MRC), stroke severity as measured by the National Institutes of Health Stroke Scale (NIHSS), and greater disability (BI), were the most significant predictors of persistent post-stroke spasticity. Patients with spasticity had worse HRQoL in terms of their physical functioning, role limitations, physical pain, and vitality. CONCLUSION:Spasticity, which affects a significant proportion of stroke survivors, was present in 35% of our patients at 12 months after stroke. It has a major impact on both ADL and HRQoL. Severe disability and muscle weakness are the most important predictors of persistent post-stroke spasticity.
Entities:
Keywords:
epidemiology; hemiplegia; predictors; quality of life; spasticity; stroke