Article

The aims of this study were to describe the prevalence and the
severity of upper-limb spasticity during the first year after stroke and to
analyze sensorimotor function, pain, reduced range of motion, and sensibility in
persons with and without spasticity. This is a longitudinal design with
assessments at days 3 and 10; week 4; and mos 3, 6, and 12. A total of 117
patients with first-ever stroke and arm paresis on day 3 were consecutively
included. Sixty-five percent were assessed at 12 mos. Upper-limb spasticity was
assessed with the Modified Ashworth Scale, and a score of 1 or greater was
considered spastic. Sensorimotor function, pain, sensibility, and joint range of
motion were assessed with the Fugl-Meyer Assessment. Impairment was defined as a
score of less than maximum on the motor and nonmotor domains of the Fugl-Meyer
Assessment. RESULTS: Spasticity was present in 25% of the patients at day 3 and
in 46% at 12 mos. In most patients with spasticity, the severity increased during
the first year after stroke. Spasticity appeared first in the elbow flexors and
later in the elbow extensors and the wrist flexors. The patients with spasticity
had significantly worse sensorimotor function and more pain, reduced joint range
of motion, and reduced sensibility. CONCLUSIONS: Spasticity developed in almost
half of the assessed patients, and the severity of spasticity increased over
time. Because spasticity and impairments related to spasticity, such as pain and
limitation in joint range of motion, influence upper extremity function
negatively, early identification and treatment of spasticity may be warranted.

Langue : ANGLAIS