What comes first, spasticity, reduced range of motion or pain in patients after stroke?

• Introduction Pain, reduced range of motion (ROM) and reduced motor function has been found to be associated with spasticity in persons with stroke, but the developments of these impairments over time are less known. The aim of the study was to describe the development of spasticity, pain, ROM, sensibility and sensory motor function in persons with first stroke during the first year after stroke. Method 117 patients with first ever stroke was recruited for the study. No selections apart from reduced arm function on day 3 were made. The patients were assessed six times during the first year, at day 3, 10, week 4, month 3, 6 and 12. Upper limb spasticity was assessed with the modified Ashworth scale (MAS), and a MAS score ≥ 1 was regarded as presence of spasticity. Sensory motor function was assessed with the Fugl-Meyer Upper-Extremity scale (FM-UE). The presence of pain, reduced sensibility and range of motion (ROM) was regarded if lower than maximum scores on the non-motor domains of the FM-UE. Results The proportion of persons with spasticity increased from 0.25 at day 3 to 0.44 at week 4 and was stable up to 12 months. Sensory motor function improved from 28 (SD 25) at day 3 to 47 (SD 23) at 3 months and was stable up to 12 months. The proportion of persons with reduced ROM was 0.45 at day 3, was stable up to 3 months and increased at 6 and 12 months, 0.55 and 0.61, respectively. The proportion of patients with reduced sensibility decreased from 0.55 at day 3 to 0.36 at 12 months. Discussion Pain, spasticity and sensory motor function seemed to develop in about parallel the first 3 months. The proportion of persons with pain continued to increase during the first year. The proportion of patients with reduced ROM was unchanged during the first three months, but increased at 6 and 12 months. Based on this, reduced upper limb ROM seems secondary to pain and spasticity.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Neurologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Neurology (hsv//eng)

Nyckelord

Stroke

spasticity

pain

joint range of motion

sensorimotor function

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