Predictors of Spasticity 3-6 Months Post Stroke: A 5-Year Retrospective Cohort Study

Objective The aim of the study is to identify predictors of poststroke spasticity (modified Ashworth Scale scores, ≥1) at 3–6 mos after stroke. Design A 5-yr (2015–2020) retrospective cohort of patients who attended inpatient stroke rehabilitation in Southwestern Ontario, Canada, were included. Sociodemographic, clinical, stroke-related, rehabilitation-related, and outcome measure data were extracted from paper charts and electronic databases. Results Of the 922 individuals attending inpatient stroke rehabilitation, 606 (55.8% males; mean age = 70.9 ± 14.2 yrs) returned for an outpatient visit. Most patients had a first ever ( n = 518; 85.5%), ischemic ( n = 470; 77.6%) stroke with hemiplegia ( n = 449, 74.1%). A total of 20.3% ( n = 122) of patients had developed poststroke spasticity by 4 mos after stroke. A binary logistic regression significantly predicted poststroke spasticity (χ 2 (6) = 111.696, P < 0.0001) with good model fit (χ 2 (8) = 12.181, P = 0.143). There were six significant poststroke spasticity predictors: hemorrhagic stroke ( P = 0.049), younger age ( P < 0.001), family history of stroke ( P = 0.015), Functional Independence Measure admission score ( P < 0.001), use of selective serotonin reuptake inhibitors ( P = 0.044), and hemiplegia ( P < 0.001). Conclusions Patients should be monitored closely for poststroke spasticity after discharge from stroke rehabilitation and throughout the care continuum.