The spasticity in the motor and functional disability in adults with post-stroke hemiparetic

Cacho, Roberta de Oliveira; Cacho, Ênio Walker Azevedo; Loureiro, Anderson Barbosa; Cirne, Gabriele Natane de Medeiros; Pereira, Silvana Alves; Freitas, Rodrigo Pegado de Abreu; Lima, Núbia Maria Freire Vieira; Borges, Guilherme

doi:10.1590/1980-5918.030.004.ao09

Cited by 11 publications

(7 citation statements)

References 29 publications

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“…Description of spasticity and its clinical implications are still having lack of attention. The prevalence of PSS in initial studies was approximately 60%; 13 however, current studies show lower rates of spasticity in 7-42% of post-stroke patients.…”

Section: Discussioncontrasting

confidence: 52%

Occurrence and Predictors of Spasticity after First-ever Stroke: A Systematic Review

Sardana¹,

Maheshwari²,

Bhushan³

et al. 2021

Indian Journal of Physical Medicine and Rehabilitation

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Aim and objective: To review recent studies on occurrence and predictors of post-stroke spasticity (PSS) after first-ever stroke. Materials and methods: A systematic search of online databases including PubMed, Elsevier, and Springer was performed for literature describing occurrences and predictors of PSS. These data were collected and analyzed. Results: Nine studies on prevalence including approximately 7,756 participants and 6 studies on predictors of PSS with approximately 755 patients were analyzed. The prevalence of PSS was 7-42% in a maximum 18-month post-stroke follow-up and increased muscle tone, greater severity of paresis, sensory impairment, and low Barthel Index score were predictors of PSS. Conclusion: Under 65 years of age, patients are more prone to developing PSS, mainly in upper limbs at one year. For the determination of PSS prevalence, multiple parameters of spasticity measurement with biomechanical factors are to be needed. Early advanced rehabilitation, with background knowledge of predictors of PSS, the functional ability can be improved to achieve better outcomes and quality of life.

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Section: Discussioncontrasting

confidence: 52%

Occurrence and Predictors of Spasticity after First-ever Stroke: A Systematic Review

Sardana¹,

Maheshwari²,

Bhushan³

et al. 2021

Indian Journal of Physical Medicine and Rehabilitation

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“…Lin et al 50 found strong reverse correlation between the grade of spasticity and the hand functions in 10 individuals suffered from spasticity and hemiplegia after stroke. A cross-sectional study performed by Cacho et al 51 examined the relationship between spasticity and limb functionality, evaluating 27 patients, finding a negative correlation between upper limb spasticity and functional impairment but not lower limb. The authors proposed that the actual influence of spasticity on functional impairment was hard to measure because the level of spasticity may change according to the position of the limb or the task being performed.…”

Section: Discussionmentioning

confidence: 99%

Effect and Optimal Timing of Extracorporeal Shock-Wave Intervention to Patients With Spasticity After Stroke

Ou-Yang

Chen

Lee³

et al. 2022

Am J Phys Med Rehabil

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Objective: This study investigated the efficacy of extracorporeal shock wave therapy as well as the optimal intervention timing for extracorporeal shock wave therapy for patients with spasticity after stroke. Design: A search of randomized controlled trials was conducted in different electronic databases. We performed a meta-analysis to measure the effect of extracorporeal shock wave therapy versus sham interventions on spasticity and limb functionality. The meta-regression analysis was performed to determine the adequate intervention timing of extracorporeal shock wave therapy. The follow-up period of the outcomes was divided into the short (<2 wks), mid (>2 wks and ≤4 wks), and long (>4 wks and ≤3 mos) terms. Results: Thirteen studies with 677 participants were evaluated. Spasticity significantly improved throughout the follow-up duration. Limb functionality significantly improved in the short-term follow-up period. The meta-regression analysis showed that patients with stroke duration less than 45 mos may be benefited from extracorporeal shock wave therapy in improving limb function in all follow-up periods. Conclusions: Extracorporeal shock wave therapy is an effective method for reducing spasticity in patients with stroke, and the effect could be maintained for up to 3 mos. Its effects on limb functionality could persist for at least 2 wks. Patients who had stroke for less than 45 mos may have significant benefit from extracorporeal shock wave therapy in all follow-up periods.

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“…After a stroke, motor unit control of the affected muscles may be lost (weakness) and voluntary muscle activation changes cause co-contraction of antagonist muscles and decreased activation of agonist muscles (Chae et al, 2002). Spasticity acts as a limiting factor to achieving upper extremity motor and functional recovery (Cacho et al, 2017). However, there were difficulties measuring the definite influence of spasticity on motor impairment after a stroke, as the level of spasticity may differ according to the task demands (Sommerfeld et al, 2004).…”

Section: Discussionmentioning

confidence: 99%

The Effectivity of Anodal Transcranial Direct Current Stimulation in Enhancing Wrist Extensor Muscle Activation After Stroke: A Randomized Trial

Zahra¹,

Andriana²,

Arfianti³

et al. 2021

IJRP

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Background: Disability in stroke patients is frequently due to upper limb motor dysfunction, in which wrist extension control plays a major role. Beneficial effects of anodal transcranial direct current stimulation (tDCS) on motor recovery after stroke have been previously reported, but data regarding its effect on wrist extensor muscle activity is limited. Objective: To investigate whether anodal tDCS has an effect on wrist extensor activation in post-stroke patients. Methods: Ten patients suffering from first ischemic stroke were randomized to either an experimental group (anodal tDCS + occupational therapy) or a control group (occupational therapy only). Anodal tDCS over ipsilesional primary motor cortex (M1) was delivered with 2 mA intensity for 20 minutes. Evaluations of wrist extensor muscle activation during isometric contraction using surface electromyography were performed before and after five days of intervention. Results: Within-group comparison in the experimental and control groups; and between-group comparison showed no significant difference in wrist extension control before and after intervention (p = 0.446, p = 0.764, and p = 0,917, respectively). Conclusions: Five sessions of anodal tDCS showed no significant effect on wrist extensor activation in post-stroke patients. Further studies with a larger sample size and a longer period of intervention are necessary to clarify the effects of tDCS on wrist extension control in stroke patients.

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The spasticity in the motor and functional disability in adults with post-stroke hemiparetic

Cited by 11 publications

References 29 publications

Occurrence and Predictors of Spasticity after First-ever Stroke: A Systematic Review

Occurrence and Predictors of Spasticity after First-ever Stroke: A Systematic Review

Effect and Optimal Timing of Extracorporeal Shock-Wave Intervention to Patients With Spasticity After Stroke

The Effectivity of Anodal Transcranial Direct Current Stimulation in Enhancing Wrist Extensor Muscle Activation After Stroke: A Randomized Trial

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