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Association Between Spasticity and Functional Impairments During the First Year After Stroke in Korea: The KOSCO
Yong-Il Shin1, Soo-Yeon Kim, Hae In Lee
1From the Department of Rehabilitation Medicine, Pusan National University School of Medicine, Research Institute of Convergence for Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea (Y-IS, S-YK, HIL, MHM); Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea (DYK); Department of Rehabilitation Medicine, Konkuk University School of Medicine, Konkuk University Medical Center, Seoul, Republic of Korea (JL); Department of Rehabilitation Medicine, School of Medicine, Chungnam National University, Daejeon, Republic of Korea (MKS); Department of Physical and Rehabilitation Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea (S-GL); Department of Preventive Medicine, Wonkwang University School of Medicine, Iksan, Republic of Korea (G-JO); Department of Rehabilitation Medicine, Kyungpook National University School of Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea (Y-SL); Department of Rehabilitation Medicine, Wonkwang University School of Medicine, Iksan, Republic of Korea (MCJ); Department of Rehabilitation Medicine, Jeju National University Hospital, Jeju National University School of Medicine, Jeju City, Republic of Korea (EYH); Department of Statistics, Hallym University, Chuncheon, Republic of Korea (JH); Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular and Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea (WHC, Y-HK); and Division of Chronic Disease Control, Korea Center for Disease Control, MOHW, Chungcheongbuk-do, Republic of Korea (YK).
Objective:
The aim of the study was to investigate the correlation between spasticity severity and functional outcomes during the first year after stroke.
Design:
The Korean Stroke Cohort for Functioning and Rehabilitation is a large, multicenter, prospective cohort study of all patients with acute first-ever stroke admitted to participating hospitals in nine Korean areas. To investigate the correlation between spasticity severity and functional status measured by using the Institutes of Health Stroke Scale (NIHSS), Modified Barthel Index (MBI), Functional Independence Measurement (FIM), Fugl-Meyer Assessment (FMA), Functional Ambulatory Category (FAC), modified Rankin scale (mRS), and American Speech-Language Hearing Association National Outcome Measurement System Swallowing Scale (ASHA-NOMS), data were analyzed at 3, 6, and 12 mos after the occurrence of stroke.
Results:
A total of 7359 stroke patients, 3056 were finally included. Prevalence rates of spasticity in patients after stroke were 6.8% at 3 mos, 6.9% at 6 mos, and 7.6% at 12 mos. The scores of mRS and NIHSS were higher and those of K-MBI, FIM, FMA, and ASHA-NOMS were lower in more severe spastic patients, indicating poorer functional outcomes (P < 0.05).
Conclusions:
This study demonstrated the coexistence of spasticity and poor functional outcome during the first year after first-ever stroke patients.
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