Early clinical predictors of post stroke spasticity

Area of Science:

• Neurology
• Rehabilitation Medicine
• Clinical Research

Background:

• Post-stroke spasticity (PSS) affects up to 40% of stroke survivors with paresis.
• PSS can lead to severe complications such as pain, contractures, and postural disorders.
• Early detection and management of PSS are critical for effective patient outcomes.

Purpose of the Study:

• To identify early predictors of PSS in the acute phase after stroke (within 7 days).
• To investigate the predictive value of common clinical scales for PSS development.
• To establish a protocol for early PSS risk assessment in clinical practice.

Main Methods:

• Prospective observational cohort study involving 145 first-ever stroke patients.
• Standardized assessment of PSS using the Resistance to Passive movement Scale (REPAS) within 7 days and 3 months post-stroke.
• Binary logistic regression analysis to identify significant clinical predictors of PSS, including the Modified Rankin Scale (MRS), National Institutes of Health Stroke Scale (NIHSS), and Mini-Mental State Examination (MMSE).

Main Results:

• 23.4% of patients developed PSS.
• MRS >2, NIHSS >2, and MMSE <27 were identified as strong predictors of PSS.
• A combination of these scales demonstrated a high positive predictive value (95.2%) for PSS (sensitivity 94.4%, specificity 93.3%).

Conclusions:

• Commonly used clinical scales (NIHSS, MRS, MMSE) are effective in identifying patients at high risk for PSS.
• Early identification of high-risk patients allows for timely intervention and management of PSS.
• Integrating these scales into stroke unit practice can improve PSS prediction and patient care.