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Does Spasticity Correlate With Motor Impairment in the Upper and Lower Limbs in Ambulatory Chronic Stroke Survivors?

AMERICAN JOURNAL OF PHYSICAL MEDICINE & REHABILITATION(2023)

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Abstract
Objective: This study aimed to explore correlations between spasticity and motor impairments in the upper and lower limbs in ambulatory chronic stroke survivors.Design: We performed clinical assessments in 28 ambulatory chronic stroke survivors with spastic hemiplegia (female: 12; male: 16; mean ages = 57.8 +/- 11.8 yrs; 76 +/- 45 mos after stroke).Results: In the upper limb, spasticity index and Fugl-Meyer Motor Assessment showed a significant correlation. Spasticity index for the upper limb showed a significant negative correlation with handgrip strength of the affected side (r = -0.4, P = 0.035) while Fugl-Meyer Motor Assessment for the upper limb had a significant positive correlation (r = 0.77, P < 0.001). In the LL, no correlation was found between SI_LL and FMA_LL. There was a significant and high correlation between timed up and go test and gait speed (r = 0.93, P < 0.001). Gait speed was positively correlated with Spasticity index for the lower limb (r = 0.48, P = 0.01), and negatively correlated with Fugl-Meyer Motor Assessment for the lower limb (r = -0.57, P = 0.002). Age and time since stroke showed no association in analyses for both upper limb and lower limb.Conclusions: Spasticity has a negative correlation on motor impairment in the upper limb but not in the lower limb. Motor impairment was significantly correlated with grip strength in the upper limb and gait performance in the lower limb of ambulatory stroke survivors.
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Key words
Stroke,Motor Impairment,Spasticity,Muscle Synergy,Gait,Fugl-Meyer Assessment
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