Lundström E, Terént A, Borg J
Department of Neuroscience, Neurology, Uppsala University Hospital, Uppsala, Sweden.
Eur J Neurol. 2008 Jun;15(6):533-9. doi: 10.1111/j.1468-1331.2008.02114.x. Epub 2008 Mar 18.
To estimate the prevalence of disabling spasticity (DS) 1 year after first-ever stroke.
Cross-sectional survey 1 year after first-ever stroke.
Patients above 18 years from one county with first-ever stroke were identified by use of the national stroke registry. A representative sample of 163 patients was created and 140 of these were followed up. Assessments of motor function and ability with the modified Ashworth Scale, the modified Rankin Scale (mRS), the Barthel Index (BI) and clinical evaluation were performed in order to identify patients with spasticity-related disability.
The observed prevalence of any spasticity was 17% and of DS 4%. Patients with DS scored significantly worse than those with no DS on the mRS (P = 0.009) and the BI (P = 0.005). DS was more frequent in the upper extremity, correlated positively with other indices of motor impairment and inversely with age. There was an independent effect of severe upper extremity paresis (OR 22, CI 3.9-125) and age below 65 years (OR 9.5, CI 1.5-60).
The prevalence of DS after first-ever stroke is low but corresponds to a large number of patients and deserves further attention with regards to prevention and treatment.
评估首次卒中后1年致残性痉挛（DS）的患病率。
首次卒中后1年的横断面调查。
利用国家卒中登记系统识别来自某县的首次卒中且年龄在18岁以上的患者。选取163例患者作为代表性样本，其中140例接受随访。采用改良Ashworth量表、改良Rankin量表（mRS）、Barthel指数（BI）及临床评估对运动功能和能力进行评估，以识别与痉挛相关残疾的患者。
观察到任何痉挛的患病率为17%，DS的患病率为4%。DS患者在mRS（P = 0.009）和BI（P = 0.005）上的得分显著低于无DS的患者。DS在上肢更常见，与其他运动障碍指标呈正相关，与年龄呈负相关。严重上肢麻痹（比值比22，可信区间3.9 - 125）和年龄低于65岁（比值比9.5，可信区间1.5 - 60）有独立影响。
首次卒中后DS的患病率较低，但涉及大量患者，在预防和治疗方面值得进一步关注。
