Article

The complexities of post-stroke spasticity (PSS), and the resultant
difficulties in treating the disability, present a significant challenge to
patients, stroke rehabilitation teams, and caregivers.
Reducing the severity of
spasticity and its long-term complications may be facilitated by early
intervention, making identification of stroke patients at high risk for
developing spasticity essential. Factors that predict which patients are at risk
for the development of PSS are identified. TYPE: Systematic search and review
LITERATURE SURVEY: A PubMed search of the following terms was conducted:
predictors OR risk factors AND stroke AND spasticity. Studies discussing
predictors of early PSS development and factors predictive of motor/functional
outcomes and recovery were selected and reviewed in detail. SYNTHESIS: Several
predictors of PSS have been proposed, based on studies conducted in patients
within 6 months after stroke, including development of increased muscle tone,
greater severity of paresis, hemihypesthesia, and low Barthel Index score.
Predictors identified in later stages post-stroke (within 12 months) have also
proved useful for clinicians, as has the consideration of predictors of motor and
functional outcomes and recovery; yet there is a need for additional studies in
this area. An understanding of these and other potential predictive factors--such
as motor impairment, neurologic and sensory deficit, lesion volume and location,
and associated diseases--has not progressed to the same extent and warrants
further investigation. CONCLUSION: The studies discussed in this review support
the notion that early identification of factors predictive of PSS should
significantly affect the course of intervention, help target individuals who
would benefit most from specific types and intensities of therapy, and possibly
provide better motor and functional outcomes.
CI - Copyright (c) 2015 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.
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Langue : ANGLAIS