Keng-He Kong, Karen Sui-Geok Chua, Jeanette Lee
DOI: 10.2340/16501977-0545

Objective: To document the frequency, clinical correlates and predictors of symptomatic upper limb spasticity in patients one year or more after stroke.
Design: Cross-sectional study.
Subjects: A total of 140 patients after stroke attending a rehabilitation clinic.
Methods: Assessments of spasticity, upper limb function and self-care ability using the Ashworth Scale (AS), Motor Assessment Scale and Modified Barthel Index. We categorized spasticity as: spasticity in general (AS score ≥1), severe spasticity (AS score ≥3) and symptomatic spasticity (spasticity affecting upper limb function).
Results: The mean age (standard deviation, SD) was 61. 0 (SD 13. 3) years and patients were evaluated at 41. 7 (SD 35. 1) months after stroke onset. The observed frequency of spasticity in general, severe spasticity and symptomatic spasticity was 78. 6%, 38. 6% and 30%, respectively. The total AS score was the most important correlate of symptomatic spasticity; patients with higher scores were likely to be symptomatic (p = 0. 001). Severe spasticity was predicted by poor lower extremity power (p = 0. 002), high National Institute of Health Stroke Scale score (p = 0. 015) and presence of dysphasia (p = 0. 046) on admission to rehabilitation. No predictors of symptomatic spasticity could be established.
Conclusion: Symptomatic spasticity is relatively common in patients with chronic stroke and is significantly correlated with the severity of spasticity.