Abstract
BackgroundSpasticity often leads to symptomatic and functional problems that can cause disability for stroke survivors. We studied whether spasticity has a negative impact on health-related quality of life (HRQoL).MethodsAs part of the Greater Cincinnati/Northern Kentucky Stroke Study (NCT00642213), 460 ischemic stroke patients were interviewed during hospitalization and then followed over time. HRQoL was measured by the Physical Component Summary (PCS) and Mental Component Summary (MCS) scores of the Short Form-12 (SF-12), EuroQol-5 dimension (EQ-5D), and Stroke-Specific Quality of Life (SSQOL) instruments, with lower scores indicating worse health. HRQoL differences between stroke survivors with and without spasticity were compared, adjusting for age, race, stroke severity, pre-stroke function, and comorbidities.ResultsOf the 460 ischemic stroke patients, 328 had spasticity data available 3 months after their stroke (mean age of 66 years, 49 % were female, and 26 % were black). Of these patients, 54 (16 %) reported having spasticity. Three months following their stroke, patients who reported spasticity had lower mean scores on the PCS (29.6 ± 1.4 vs 37.3 ± 0.6; P < .001), EQ-5D (0.59 ± 0.03 vs 0.71 ± 0.01; P < .001), and SSQOL (3.57 ± 0.08 versus 3.78 ± 0.03; P = .03) compared with patients who did not report spasticity. Lower HRQoL scores were also observed at the 1-year (PCS, EQ-5D, and SSQOL) and 2-year (EQ-5D and SSQOL) interviews in those with spasticity compared with those without spasticity.ConclusionsStatistically and clinically meaningful differences in HRQoL exist between stroke survivors with and without spasticity.
Highlights
Spasticity often leads to symptomatic and functional problems that can cause disability for stroke survivors
Over the 3 poststroke time points, 365 patients had spasticity data available at some point during follow-up, and those patients were included in the longitudinal health-related quality of life (HRQoL) models
The results of this study demonstrate that the presence of spasticity independently impacts the HRQoL of stroke survivors
Summary
Spasticity often leads to symptomatic and functional problems that can cause disability for stroke survivors. Spasticity, a sensorimotor disorder characterized by a velocity-dependent increase in muscle tone with exaggerated tendon jerks, spasticity can be regional or generalized, stroke survivors commonly experience focal spasticity in their upper and/or lower limbs. In an analysis by Urban and colleagues, PSS in the upper and/or lower limbs occurred in approximately 43 % of patients 6 months after stroke among patients with clinical signs of central paresis [4]. Stroke survivors with spasticity often experience secondary limb deformities, physical disability, and pain that limits their ability to perform basic activities of daily living, such as holding or picking up objects, self-care, and ambulation.
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