Absence of upper limb movement within 72 hours of acute ischemic stroke predicts later spasticity

   According to a study by Wayne Feng, MD, MS, of the Medical University of South Carolina in Charleston, and colleagues, the absence of upper limb movement within 72 hours after acute ischemic stroke predicts spasticity at three months.

   The researchers prospectively followed a cohort of patients (N=22) who presented with their first-ever acute ischemic stroke; there were various degree of motor impairment. The first motor assessment (absence or presence of upper limb movement) was done within 72 hours of the event; the second at three months (+/-2 weeks) after. The patients were classified as having spasticity if the Modified Asworth Scale was >/=2 and no spasticity if the MAS was 0 or 1. 

   According to Dr. Feng and colleagues, 85.7% of patients who had no upper limb movement within 72 hours developed spasticity three months after stroke. But only 13.3% of patients who had limb movement developed spasticity (P=0.0005). The sensitivity, specificity, positive predictive value, and negative predictive value were 75.0%, 92.9%, 85.7%, and 86.7%, respectively. 

   “Our data suggests that a simple motor assessment within 72 hours -- presence or absence of upper limb movement -- can accurately predict spasticity at three months,” the researchers concluded. However, they noted that the data must be validated in a large study.