Background The lower limb spasticity after stroke can affect the balance and gait of patients with stroke. Objective The aim of this study is to assess the effects of ankle plantar flexor spasticity level on balance in patients with stroke. Methods Patients with stroke were recruited from neurology and physiotherapy clinics in Tehran, Iran. Based on the level of ankle plantar flexor spasticity according to the Modified Modified Ashworth Scale (MMAS), the eligible patients with stroke were divided into 2 groups: high spasticity (MMAS score≥2) and low spasticity (MMAS score<2). The primary outcome measures were the MMAS scores, Activities-Specific Balance Confidence questionnaire scores, eyes-open and eyes-closed posturography measures, and Timed Up and Go test results. The secondary outcome measures were the ankle passive range of motion and ankle joint proprioception. The t test, mixed model univariate analysis of variance, and Spearman rank correlation were used for statistical analysis. Results Data collection and statistical analysis are complete. The interpretation of results is underway. We expect the results to be published in winter 2020. Conclusions We believe that patients with high ankle plantar flexor spasticity after stroke will demonstrate greater balance dysfunction, which will worsen with impaired proprioception, passive range of motion, and eyes closed. International Registered Report Identifier (IRRID) RR1-10.2196/16045

Background: Lower limb spasticity after stroke is common that can affect the balance, increase the risk of falling, and reduces the quality of life.Objective: First, evaluate the effects of spasticity severity of ankle plantar flexors on balance of patients after stroke. Second, to determine the relationship between the spasticity severity with ankle proprioception, passive ankle dorsiflexion range of motion (ROM), and balance confidence.Methods: Twenty-eight patients with stroke based on the Modified Modified Ashworth Scale (MMAS) were divided into two groups: High Spasticity Group (HSG) (MMAS &gt; 2) (n = 14) or a Low Spasticity Group (LSG) (MMAS ≤ 2) (n = 14). The MMAS scores, Activities-Specific Balance Confidence Questionnaire, postural sway of both affected and non-affected limbs under the eyes open and eyes closed conditions, timed up and go (TUG) test, passive ankle dorsiflexion ROM, and ankle joint proprioception were measured.Results: The ankle joint proprioception was significantly better in the LSG compared to the HSG (p = 0.01). No significant differences were found between the LSG and HSG on all other outcome measures. There were no significant relationships between the spasticity severity and passive ankle dorsiflexion ROM, and balance confidence.Conclusion: The severity of ankle plantar flexor spasticity had no effects on balance of patients with stroke. However, the ankle joint proprioception was better in patients with low spasticity. Our findings suggest that the balance is affected regardless of the severity of the ankle plantar flexor spasticity in this group of participants with stroke.

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BACKGROUND The lower limb spasticity after stroke can affect the balance and gait of patients after stroke. OBJECTIVE The aim of this study is to assess the effects of ankle plantar flexors spasticity level on balance in patients after stroke. METHODS Patients with stroke will be recruited from neurology and physiotherapy clinics in Tehran, Iran. The eligible patients with stroke will be divided into two groups based on the level of ankle plantar flexor spasticity according to the Modified Modified Ashworth Scale (MMAS) as high (MMAS≥2) and low (MMAS<2). The primary outcome measures will be the MMAS scores, Activities-specific balance confidence questionnaire, posturography measures in open and closed eyes conditions, and the timed up and go test. The secondary outcome measures are the ankle passive range of motion and ankle joint proprioception. RESULTS The patients with high ankle plantar flexor spasticity will show greater impairments in the balance confidence, passive range of motion, ankle proprioception, timed up and go test, and posturography measures. The patients with high spasticity level will show greater balance impairments in the eyes closed condition when compared to patients with low spasticity level and with eyes open. There will be positive relationships between the ankle plantar flexor spasticity level with the balance confidence scores and the impairments in ankle proprioception, ankle passive range of motion, and timed up and go test. CONCLUSIONS The patients with high ankle plantar flexor spasticity after stroke will demonstrate greater balance dysfunction which is worsened with impairments of proprioception, passive range of motion, and eyes closed. CLINICALTRIAL Not a clinical trial.