Increased muscle tone and contracture late after ischemic stroke

Area of Science:

• Neurology
• Rehabilitation Medicine
• Stroke Research

Background:

• Limited systematic studies exist on long-term increased muscle tone and spasticity following ischemic stroke.
• Understanding the prevalence and predictors of post-stroke muscle tone abnormalities is crucial for patient management.
• This study addresses the gap in knowledge regarding late-onset muscle tone issues after ischemic stroke.

Purpose of the Study:

• To determine the prevalence of increased muscle tone, classical spasticity, and contracture seven years after ischemic stroke.
• To identify predictors of increased muscle tone in patients who experienced ischemic stroke before age 70.

Main Methods:

• Recruited 411 patients with acute ischemic stroke (<70 years) into the Sahlgrenska Academy Study on Ischemic Stroke.
• Assessed symptoms at index stroke using the Scandinavian Stroke Scale.
• Follow-up assessments at seven years included 292 participants (288 with data), evaluating muscle tone (Modified Ashworth scale), spasticity, and contracture by a neurologist. Logistic regression analyzed associations with baseline characteristics and recurrent strokes.

Main Results:

• Increased muscle tone was observed in 34% (99/288) of participants, affecting upper limbs in 33% and lower limbs in 25%.
• Classical spasticity was present in 18% (51/288) and contracture in 9% (26/288).
• Independent predictors of increased muscle tone included older age (OR 1.03), arm paresis (OR 1.76), aphasia (OR 1.68), and facial palsy (OR 2.12) at the time of the index stroke.

Conclusions:

• One-third of ischemic stroke patients under 70 experienced increased muscle tone seven years post-stroke, with half also showing spasticity.
• Age, arm paresis, aphasia, and facial palsy are significant predictors of developing increased muscle tone after stroke.
• Findings underscore the importance of monitoring for and managing long-term motor impairments following ischemic stroke.