The negative impact of spasticity on the health-related quality of life of stroke survivors: a longitudinal cohort study

• Type of Material: Article
• Authors: Patrick J. Gillard, Allergan, Inc; Heidi Sucharew, Cincinnati Children’s Hospital Medical Center; Dawn Kleindorfer, University of Cincinnati; Samir Belagaje, Emory University; Sepideh Varon, Allergan, Inc.; Kathleen Alwell, University of Cincinnati; Charles J. Moomaw, University of Cincinnati; Daniel Woo, University of Cincinnati; Pooja Khatri, University of Cincinnati; Matthew L. Flaherty, University of Cincinnati; Opeolu Adeoye, University of Cincinnati; Simona Ferioli, University of Cincinnati; Brett Kissela, University of Cincinnati
• Language: English
• Date: 2015-12
• Publisher: BioMed Central
• Publication Version: Final Published Version
• Copyright Statement: © Gillard et al. 2015
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1186/s12955-015-0340-3
• Title of Journal or Parent Work: Health and Quality of Life Outcomes
• ISSN: 1477-7525
• Volume: 13
• Issue: 1
• Grant/Funding Information: This study was partially funded by National Institute of Neurological Disorders and Stroke grant R01NS30678.
• Keywords: Stroke; spasticity; stroke rehabilitation; quality of life
• Research Categories: Health Sciences, Mental Health; Health Sciences, Epidemiology; Biology, Neuroscience

Abstract

Each year, 15 million people worldwide, including approximately 795,000 Americans, experience a new or recurrent stroke [1, 2]. Stroke ranks fourth among all causes of death and is a leading cause of serious, long-term disability in the United States [2]. Spasticity, a sensorimotor disorder characterized by a velocity-dependent increase in muscle tone with exaggerated tendon jerks, has been estimated to occur in up to 46 % of patients 12 months after stroke [3–5]. Although spasticity can be regional or generalized, stroke survivors commonly experience focal spasticity in their upper and/or lower limbs. In an analysis by Urban and colleagues, PSS in the upper and/or lower limbs occurred in approximately 43 % of patients 6 months after stroke among patients with clinical signs of central paresis [4]. Stroke survivors with spasticity often experience secondary limb deformities, physical disability, and pain that limits their ability to perform basic activities of daily living, such as holding or picking up objects, self-care, and ambulation. Stroke survivors with spasticity also often suffer from psychological and emotional issues, such as depression and poor self-image [6]. As a result, spasticity has been hypothesized to have a significant negative impact on the health-related quality of life (HRQoL) of stroke survivors. To date, the published evidence to support this negative association is limited [7]. Most existing supportive information comes from clinical trials that are short in duration and not generalizable to the United States population. Given the extent to which spasticity is present in stroke survivors and the paucity of data examining the impact of spasticity on stroke survivors’ HRQoL, we utilized a longitudinal cohort study of stroke survivors to examine the impact of spasticity on HRQoL.