Prevalence and management of poststroke spasticity in Thai stroke patients: A multicenter study

Objectives: To study the prevalence, associated factors and management of poststroke spasticity in two muscle groups namely elbow flexor and knee flexor. Material and Method: The Thai stroke rehabilitation registry (TSRR) was conducted among 9 rehabilitation centers. All subjects received the conven...

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Main Authors: Piyapat Dajpratham, Vilai Kuptniratsaikul, Apichana Kovindha, Patcharawimol Srisa An Kuptniratsaikul, Kalaya Dejnuntarat
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Published: 2018
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http://cmuir.cmu.ac.th/jspui/handle/6653943832/49298
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Institution: Chiang Mai University
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spelling th-cmuir.6653943832-492982018-08-16T02:14:06Z Prevalence and management of poststroke spasticity in Thai stroke patients: A multicenter study Piyapat Dajpratham Vilai Kuptniratsaikul Apichana Kovindha Patcharawimol Srisa An Kuptniratsaikul Kalaya Dejnuntarat Medicine Objectives: To study the prevalence, associated factors and management of poststroke spasticity in two muscle groups namely elbow flexor and knee flexor. Material and Method: The Thai stroke rehabilitation registry (TSRR) was conducted among 9 rehabilitation centers. All subjects received the conventional rehabilitation program until they reached their rehabilitation goals or discharge criteria. The Brunnstrom motor recovery stage, Barthel Index, Thai Mental State Examination, Modified Ashworth Scale (MAS), and WHOQOL-BREF-Thai(26 items) questionnaires were used to assess the motor recovery, functional disability, cognition, spasticity and quality of life on admission respectively. The management of spasticity was also recorded. Results: There were 327 patients with a mean age of 62.2 years old participating in the study. The prevalence of poststroke spasticity was 41.6%. Among these the prevalences of spasticity of both elbow and knee flexors was 31.2% and of either elbow or knee flexor were 4.9% and 5.5% respectively. Spasticity with MAS grade 1 was found in the majority. The patients with spasticity had a significantly longer time to rehabilitation admission interval after the stroke (p = 0.049), had the Brunnstrom motor recovery stages of arm (p < 0.001), hand (p = 0.003) and leg (p < 0.001) significantly lower than the no spasticity group. The factor associated with spasticity was Brunnstrom motor recovery stage 2 and 3 of the arm with the odds ratio being 6.1 (95% CI = 2.5-14.9) and 3.5 respectively (95% CI = 1.3-9.2). Management of spasticity was demonstrated in 83 patients (25.4%). Therapeutic exercise, oral antispastic medication and assistive device were the first three managements frequently prescribed respectively. Conclusion: Spasticity was a common complication after stroke. Although the prevalence was quite high, spasticity with MAS grade 1 was found in the majority of cases. The associated factor was the Brunnstrom motor recovery stage of the arm. Therapeutic exercise was the mainstay of the management. 2018-08-16T02:14:06Z 2018-08-16T02:14:06Z 2009-10-01 Journal 01252208 01252208 2-s2.0-70350452137 https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=70350452137&origin=inward http://cmuir.cmu.ac.th/jspui/handle/6653943832/49298
institution Chiang Mai University
building Chiang Mai University Library
country Thailand
collection CMU Intellectual Repository
topic Medicine
spellingShingle Medicine
Piyapat Dajpratham
Vilai Kuptniratsaikul
Apichana Kovindha
Patcharawimol Srisa An Kuptniratsaikul
Kalaya Dejnuntarat
Prevalence and management of poststroke spasticity in Thai stroke patients: A multicenter study
description Objectives: To study the prevalence, associated factors and management of poststroke spasticity in two muscle groups namely elbow flexor and knee flexor. Material and Method: The Thai stroke rehabilitation registry (TSRR) was conducted among 9 rehabilitation centers. All subjects received the conventional rehabilitation program until they reached their rehabilitation goals or discharge criteria. The Brunnstrom motor recovery stage, Barthel Index, Thai Mental State Examination, Modified Ashworth Scale (MAS), and WHOQOL-BREF-Thai(26 items) questionnaires were used to assess the motor recovery, functional disability, cognition, spasticity and quality of life on admission respectively. The management of spasticity was also recorded. Results: There were 327 patients with a mean age of 62.2 years old participating in the study. The prevalence of poststroke spasticity was 41.6%. Among these the prevalences of spasticity of both elbow and knee flexors was 31.2% and of either elbow or knee flexor were 4.9% and 5.5% respectively. Spasticity with MAS grade 1 was found in the majority. The patients with spasticity had a significantly longer time to rehabilitation admission interval after the stroke (p = 0.049), had the Brunnstrom motor recovery stages of arm (p < 0.001), hand (p = 0.003) and leg (p < 0.001) significantly lower than the no spasticity group. The factor associated with spasticity was Brunnstrom motor recovery stage 2 and 3 of the arm with the odds ratio being 6.1 (95% CI = 2.5-14.9) and 3.5 respectively (95% CI = 1.3-9.2). Management of spasticity was demonstrated in 83 patients (25.4%). Therapeutic exercise, oral antispastic medication and assistive device were the first three managements frequently prescribed respectively. Conclusion: Spasticity was a common complication after stroke. Although the prevalence was quite high, spasticity with MAS grade 1 was found in the majority of cases. The associated factor was the Brunnstrom motor recovery stage of the arm. Therapeutic exercise was the mainstay of the management.
format Journal
author Piyapat Dajpratham
Vilai Kuptniratsaikul
Apichana Kovindha
Patcharawimol Srisa An Kuptniratsaikul
Kalaya Dejnuntarat
author_facet Piyapat Dajpratham
Vilai Kuptniratsaikul
Apichana Kovindha
Patcharawimol Srisa An Kuptniratsaikul
Kalaya Dejnuntarat
author_sort Piyapat Dajpratham
title Prevalence and management of poststroke spasticity in Thai stroke patients: A multicenter study
title_short Prevalence and management of poststroke spasticity in Thai stroke patients: A multicenter study
title_full Prevalence and management of poststroke spasticity in Thai stroke patients: A multicenter study
title_fullStr Prevalence and management of poststroke spasticity in Thai stroke patients: A multicenter study
title_full_unstemmed Prevalence and management of poststroke spasticity in Thai stroke patients: A multicenter study
title_sort prevalence and management of poststroke spasticity in thai stroke patients: a multicenter study
publishDate 2018
url https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=70350452137&origin=inward
http://cmuir.cmu.ac.th/jspui/handle/6653943832/49298
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