Prevalence and Treatment Characteristics of Spastic Hypertonia on First-Time Admission to Acute Inpatient Rehabilitation

Abstract

The aim of the study was to report the prevalence of spasticity and treatment patterns during first-time admission to inpatient rehabilitation after acute stroke, traumatic brain injury, and spinal cord injury. Design: This is a retrospective cohort study. Methods: A review of 285 adult patients consecutively admitted to inpatient rehabilitation was conducted. Patients with a history of spasticity and inpatient rehabilitation course and those younger than 18 yrs were excluded. Main outcome measures are as follows: admitting diagnosis, length of stay, time from injury to admission, acute transfer rate, prevalence and severity of spasticity using Modified Ashworth Scale at admission and discharge, Functional Independence Measure scores at admission and discharge, Functional Independence Measure efficiency, and treatments for spasticity. Results: Stroke patients had the highest prevalence of spasticity: 68% on admission and 50% at discharge. In traumatic brain injury, spasticity prevalence was 55% on admission and 30% at discharge. In spinal cord injury, spasticity prevalence was 48% on admission and 46% at discharge. Patients with spinal cord injury received the most medications to control spasticity, whereas those with traumatic brain injury and stroke received the most procedural interventions. Conclusions: Spasticity is a common sequela of upper motor neuron injury for patients admitted to inpatient rehabilitation. Early recognition and management are essential to prevent contractures, minimize pain, and maximize functional recovery.

May Spasticity-Related Unpleasant Sensations Interfere with Daily Activities in People with Stroke and Traumatic Brain Injury? Secondary Analysis from the CORTOX Study

“…Spasticity is a positive symptom of a complex condition called Upper Motor Neuron Syndrome (UMNS) [ 1 ] that affects up to 30% of patients with Stroke or Traumatic Brain Injury (TBI) [ 2 , 3 ]. Stroke and TBI are classified as subtypes of acquired brain injury, which encompasses brain damage incurred post-birth due to traumatic or non-traumatic causes [ 4 ].…”

The Role of Botulinum Toxin Type-A in Spasticity: Research Trends from a Bibliometric Analysis

“…It is characterized by a velocity-dependent increase in muscle tone and reflexes [2]. Its prevalence varies according to the underlying condition, with estimates indicating its occurrence in 25.3% to 39.5% of stroke survivors [3], up to 60% of multiple sclerosis patients [4], up to 30% of patients with traumatic brain injury [5], and more than 80% of the population with cerebral palsy [6]. Spasticity, aside from its cerebral and spinal causes, can also have a genetic basis, as evidenced in hereditary spastic paraplegias, which affect between two and five individuals per 100,000 worldwide [3].…”

Phenotypes of Motor Deficit and Pain after Experimental Spinal Cord Injury

“…SCI leads to multiple functional impairments that require complex care. Among the most prevalent outcomes of SCI are motor deficits that can exacerbate with time, causing chronic disability and nociceptive hypersensitivity [ 2 , 3 , 4 , 5 , 6 ]. Changes in nociceptive sensitivity can time-dependently reverse back to pre-injury level but more often give rise to chronic pain syndrome, with prevalence rates above 50% [ 7 , 8 , 9 , 10 , 11 ].…”