Predictors of Spasticity in First-Ever Stroke Patients

Background and Objectives: Post-stroke spasticity is a common and disabling complication that hinders functional recovery. The aim of this study was to identify admission variables associated with the development of spasticity in patients with first-ever stroke. Methods: This prospective observational study enrolled consecutive adults with clinically and radiologically confirmed ischemic or hemorrhagic stroke within 7 days of onset, from July 2019 to September 2020. Baseline demographic, clinical, and radiological data were collected. The primary outcome was spasticity at 3 months, defined as a Modified Ashworth Scale score of 1 or higher in at least one affected joint. Results: Of 160 eligible patients, 149 completed follow-up and were analyzed. Spasticity developed in 106 patients (71.14%) at 3 months. In multivariable logistic regression, only the admission National Institutes of Health Stroke Scale score was strongly associated with an increased risk of spasticity at 3 months (adjusted odds ratio: 2.17, 95% confidence interval: 1.53–3.07). Conclusions: Simple bedside markers available during acute stroke management may help identify patients at high risk of developing spasticity. The initial stroke severity is the strongest predictor of subsequent spasticity.