Neurological Rehabilitation Hospital, Kliniken Beelitz GmbH, Paracelsusring 6a, Beelitz-Heilstätten, Germany.
J Neurol. 2010 Jul;257(7):1067-72. doi: 10.1007/s00415-010-5463-1. Epub 2010 Feb 6.
This study followed a cohort of 103 patients at median 6 days, 6 and 16 weeks after stroke and recorded muscle tone, pain, paresis, Barthel Index and quality of life score (EQ-5D) to identify risk-factors for development of spasticity. 24.5% of stroke victims developed an increase of muscle tone within 2 weeks after stroke. Patients with spasticity had significantly higher incidences of pain and nursing home placement and lower Barthel and EQ-5D scores than patients with normal muscle tone. Early predictive factors for presence of severe spasticity [modified Ashworth scale score (MAS) >or=3] at final follow-up were moderate increase in muscle tone at baseline and/or first follow-up (MAS = 2), low Barthel Index at baseline, hemispasticity, involvement of more than two joints at first follow-up, and paresis at any assessment point. The study helps to identify patients at highest risk for permanent and severe spasticity, and advocates for early treatment in this group.
本研究对 103 名患者进行了随访，中位时间分别为卒中后 6 天、6 周和 16 周，记录了肌肉张力、疼痛、偏瘫、巴氏指数和生活质量评分（EQ-5D），以确定痉挛发生的风险因素。24.5%的卒中患者在卒中后 2 周内出现肌肉张力增加。痉挛患者的疼痛发生率、入住养老院的比例以及巴氏指数和 EQ-5D 评分均明显低于肌肉张力正常的患者。在最终随访时存在严重痉挛（改良 Ashworth 量表评分（MAS）≥3）的早期预测因素为基线和/或首次随访时出现中度肌肉张力增加（MAS=2）、基线时巴氏指数较低、偏瘫、首次随访时涉及两个以上关节以及任何评估点时存在偏瘫。该研究有助于确定永久性和严重痉挛风险最高的患者，并主张对该组患者进行早期治疗。
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