Prevalence of spasticity post stroke

Objectives: To establish the prevalence of spasticity 12 months after stroke and examine its relationship with functional ability. Design: A cohort study of prevalence of spasticity at 12 months post stroke. Setting: Initially hospitalized but subsequently community-dwelling stroke survivors in Liverpool, UK. Subjects: One hundred and six consecutively presenting stroke patients surviving to 12 months. Main outcome measures: Muscle tone measured at the elbow using the Modified Ashworth Scale and at several joints, in the arms and legs, using the Tone Assessment Scale; functional ability using the modified Barthel Index. Results: Increased muscle tone (spasticity) was present in 29 (27%) and 38 (36%) of the 106 patients when measured using the Modified Ashworth Scale and Tone Assessment Scale respectively. Combining the results from both scales produced a prevalence of 40 (38%). Those with spasticity had significantly lower Barthel scores at 12 months (p < 0.0001). Conclusion: When estimating the prevalence of spasticity it is essential to assess both arms and legs, using both scales. Despite measuring tone at several joints, spasticity was demonstrated in only 40 (38%) patients, lower than previous estimates.