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Göteborgs universitets publikationer

Is upper-limb sensorimotor function or spasticity the best predictor for spasticity one year poststroke?

Författare och institution:
Arve Opheim (Institutionen för neurovetenskap och fysiologi, sektionen för klinisk neurovetenskap och rehabilitering); Margit Alt Murphy (Institutionen för neurovetenskap och fysiologi, sektionen för klinisk neurovetenskap och rehabilitering); Anna Danielsson (Institutionen för neurovetenskap och fysiologi, sektionen för klinisk neurovetenskap och rehabilitering); Hanna C Persson (Institutionen för neurovetenskap och fysiologi, sektionen för klinisk neurovetenskap och rehabilitering); Katharina S Sunnerhagen (Institutionen för neurovetenskap och fysiologi, sektionen för klinisk neurovetenskap och rehabilitering)
Publicerad i:
World Conference in Physical Therapy, Singapore; 05/2015 ,
Publikationstyp:
Konferensbidrag, övrigt
Publiceringsår:
2015
Språk:
engelska
Sammanfattning (abstract):
ABSTRACT: Background: Clinical assessments of body functions are an important part of physiotherapy practice poststroke. These assessments are used to plan treatments, and may be used to indicate future function. Upper limb spasticity has been found to be associated with poorer motor function and muscle strength, pain and higher dependence in daily life. Therefore, the identification of patients at risk of developing spasticity may be important. Whether sensorimotor function or spasticity during the first month is the better predictor for spasticity after 1 year is unknown. Purpose: The aim was to investigate whether sensorimotor function or spasticity assessed 4 weeks poststroke was the better predictor for spasticity after 1year. Methods: One hundred and seventeen patients in Gothenburg, Sweden, with first ever stroke and impaired upper-limb function on day 3 was included in this study. The clinical assessments were made 4 weeks and 1 year poststroke. Sensorimotor function was assessed with Fugl-Meyer Upper Extremity scale (FMA-UE), and higher score indicate better function (0-66). Spasticity in elbow flexors and extensors, wrist flexors and extensors, was assessed with the modified Ashworth Scale (MAS), with higher score indicating more spasticity (0-5). The MAS score was dichotomized into: 0=no spasticity and ≥1=spasticity present, and spasticity in any of these muscle groups was regarded as spasticity present. Univariate and multivariate logistic regression analysis was used to analyze the predictors, and odds ratio and 95% were calculated. Results: In univariate analysis, both FMA-UE and MAS were significantly associated with spasticity at one year poststroke. I the multivariate analysis, only FMA-UE (OR 0.91, 95%CI: 0.88-0.95) and age (OR 0.94, 95% CI: 0.89-0.99), was significant predictors for spasticity at 1 year post stroke. Conclusion(s): When both MAS and FMA-UE was analyzed together and controlled for in a multivariate regression analysis, only FMA-UE was significantly associated with spasticity after 1 year. Better sensorimotor function was associated with reduced OR for spasticity. Also, higher age had reduced OR for spasticity. This may imply that upper limb spasticity at 4 weeks poststroke may still be an “unstable” impairment, and not yet manifest. Therefore, sensorimotor function seems to be a better predictor than spasticity 4 weeks after for spasticity one year poststroke. Implications: Poorer sensorimotor function was associated with long-term spasticity and therefore important to assess in the first month poststroke. Assessment of spasticity within the first month to predict long-term spasticity poststroke may be limited. Keywords: Stroke, spasticity, sensorimotor function, clinical assessment scales.
Ämne (baseras på Högskoleverkets indelning av forskningsämnen):
MEDICIN OCH HÄLSOVETENSKAP ->
Klinisk medicin
MEDICIN OCH HÄLSOVETENSKAP ->
Hälsovetenskaper
Nyckelord:
Stroke, spasticity, sensorimotor function, clinical assessment scales
Ytterligare information:
http://www.sciencedirect.com.ezproxy.ub.gu.se/science/article/pii/S0031940615020933
Postens nummer:
227969
Posten skapad:
2015-12-11 10:17
Posten ändrad:
2016-06-01 11:15

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