Institute of Neuroscience and Physiology, Department of Clinical Neuroscience, Rehabilitation Medicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.
Region Västra Götaland, Department of Physiotherapy, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden.
Brain Behav. 2020 Feb;10(2):e01509. doi: 10.1002/brb3.1509. Epub 2020 Jan 1.
Systematic studies on increased muscle tone and spasticity late after ischemic stroke, without any selection, are limited. Therefore, we aimed to determine the prevalence of increased muscle tone, classical spasticity and contracture and predictors of increased muscle tone seven years after stroke.
Consecutive patients with acute ischemic stroke <70 years of age (n = 411) were recruited to the Sahlgrenska Academy Study on Ischemic Stroke. Symptoms at index stroke were assessed using the Scandinavian Stroke Scale. Seven years after stroke, survivors (n = 358) were invited for follow-up assessments, of whom 292 agreed to participate and 288 contributed data. Muscle tone according to the Modified Ashworth scale, classical spasticity, and contracture was assessed by a neurologist. The associations between increased muscle tone and characteristics at index stroke and recurrent strokes during follow-up were investigated using logistic regression analysis.
Increased muscle tone was recognized in 99 participants (34%): 94 (33%) in the upper limbs, and 72 (25%) in the lower limbs. Classical spasticity was found in 51 participants (18%) and contracture in 26 (9%). Age (odds ratio [OR] 1.03 [95% confidence interval [CI] 1.00-1.06]), arm paresis (OR 1.76 [95% CI 1.40-2.2]), aphasia (OR 1.68 [95% CI 1.12-2.51]), and facial palsy (OR 2.12 [95% CI 1.10-4.07]) were independent predictors of increased muscle tone.
One-third of patients with ischemic stroke before 70 years of age showed increased muscle tone at 7-year follow-up. Half of them also had classical spasticity. Age, arm paresis, aphasia, and facial palsy at index stroke were predictors of increased muscle tone poststroke.
系统研究缺血性中风后晚期肌肉张力增加和痉挛，但未进行任何选择，因此，我们旨在确定中风 7 年后肌肉张力增加、经典痉挛和挛缩的患病率及预测因素。
连续招募 411 例年龄<70 岁的急性缺血性卒中患者参加萨赫勒格伦斯卡学院缺血性卒中研究。采用斯堪的纳维亚卒中量表评估指数卒中时的症状。中风 7 年后，幸存者（n=358）受邀进行随访评估，其中 292 人同意参加，288 人提供了数据。由神经科医生评估改良 Ashworth 量表的肌肉张力、经典痉挛和挛缩。采用逻辑回归分析调查指数卒中时的特征以及随访期间复发性卒中与肌肉张力增加之间的相关性。
99 名参与者（34%）出现肌肉张力增加：上肢 94 名（33%），下肢 72 名（25%）。51 名参与者存在经典痉挛，26 名参与者存在挛缩。年龄（比值比 [OR] 1.03 [95%置信区间 [CI] 1.00-1.06]）、手臂瘫痪（OR 1.76 [95% CI 1.40-2.2]）、失语症（OR 1.68 [95% CI 1.12-2.51]）和面瘫（OR 2.12 [95% CI 1.10-4.07]）是肌肉张力增加的独立预测因素。
70 岁以下缺血性卒中患者中有 1/3 在 7 年随访时出现肌肉张力增加，其中一半还存在经典痉挛。指数卒中时的年龄、手臂瘫痪、失语症和面瘫是中风后肌肉张力增加的预测因素。
