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Predictors of Spasticity 3-6 Mos After Stroke: A 5-Yr Retrospective Cohort Study
Amanda McIntyre1, Robert Teasell, Marcus Saikaley
1From the Arthur Labatt Family School of Nursing, Western University, London, Ontario, Canada (AM); Lawson Health Research Institute, London, Ontario, Canada (AM); Parkwood Institute Research, Parkwood Institute, London, Ontario, Canada (RT, MS, TM); Physical Medicine and Rehabilitation, St. Joseph's Health Care London, Parkwood Institute, London, Ontario, Canada (RT, TM); and Department of Physical Medicine and Rehabilitation, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada (RT, TM).
Objective:
The aim of the study is to identify predictors of poststroke spasticity (modified Ashworth Scale scores, ≥1) at 3-6 mos after stroke.
Design:
A 5-yr (2015-2020) retrospective cohort of patients who attended inpatient stroke rehabilitation in Southwestern Ontario, Canada, were included. Sociodemographic, clinical, stroke-related, rehabilitation-related, and outcome measure data were extracted from paper charts and electronic databases.
Results:
Of the 922 individuals attending inpatient stroke rehabilitation, 606 (55.8% males; mean age = 70.9 ± 14.2 yrs) returned for an outpatient visit. Most patients had a first ever ( n = 518; 85.5%), ischemic ( n = 470; 77.6%) stroke with hemiplegia ( n = 449, 74.1%). A total of 20.3% ( n = 122) of patients had developed poststroke spasticity by 4 mos after stroke. A binary logistic regression significantly predicted poststroke spasticity (χ 2 (6) = 111.696, P < 0.0001) with good model fit (χ 2 (8) = 12.181, P = 0.143). There were six significant poststroke spasticity predictors: hemorrhagic stroke ( P = 0.049), younger age ( P < 0.001), family history of stroke ( P = 0.015), Functional Independence Measure admission score ( P < 0.001), use of selective serotonin reuptake inhibitors ( P = 0.044), and hemiplegia ( P < 0.001).
Conclusions:
Patients should be monitored closely for poststroke spasticity after discharge from stroke rehabilitation and throughout the care continuum.
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