Approximately 60,000 people in Romania experience a stroke each year, and a common complication following a stroke is spasticity. This condition, which affects muscles and mobility, can significantly limit a patient’s independence. Recognizing and addressing spasticity is crucial for improving recovery and quality of life after a stroke, as it is a leading cause of disability in the country.
Spasticity after stroke is characterized by involuntary muscle contractions that can cause painful stiffness and abnormal positioning of limbs. Affected arms may be bent and held close to the body with a clenched fist, while legs can exhibit scissoring of the thighs, locked knees, or flexed toes. These positions can make everyday activities like walking, personal hygiene, and dressing extremely challenging. The condition can develop relatively soon after a stroke, with around 25% of patients showing symptoms within two weeks, and that number rises to 38% after one year and 44% for those with recurrent strokes.
Early intervention is key to managing spasticity and preventing long-term loss of joint range of motion. The process of soft tissue shortening, leading to restricted movement, joint stiffness, and chronic pain, typically begins two weeks after the onset of spasticity and can peak within three months.
While spasticity can be treated, leaving it unaddressed can lead to decreased independence, a reduced quality of life, and increased burden on caregivers. A multidisciplinary approach involving neurologists, rehabilitation physicians, and family members is essential for effective management.
“The primary goal of the neurologist is to save the patient’s life during the acute phase of a stroke, but it is equally important to inform the patient and family that early medical rehabilitation can prevent spasticity and significantly improve independence and quality of life,” says Prof. Univ. Dr. Cristina Tiu, Head of Neurology II at SUUB.
Rehabilitation plays a vital role in managing spasticity, with physical therapy, specific exercises, and appropriate medication proving effective in preventing muscle contractures and maintaining mobility. Family support is also crucial, encouraging patients to adhere to their treatment plan and perform exercises at home.
“Even though patients with post-stroke spasticity are not always the easiest to treat, physical therapy, specific exercises, and appropriate medication can make a difference. The role of the family is essential: their support and involvement in the recovery program increase the chances of therapy success,” says Prof. Univ. Dr. Delia Cinteză, a Physical Medicine and Rehabilitation specialist at INRMFB.
Early intervention, combining multiple therapies, is associated with a higher degree of recovery of motor functions, increased independence, and improved quality of life for both patients and their families. Detecting symptoms early and involving the family are essential steps in improving outcomes.
Sources:
1. SUUB, Accidentul vascular cerebral (AVC) – Cum se manifestă și cum se intervine (https://www.suub.ro/sfaturi-medicale/accidentul-vascular-cerebral-avc/)
2. Spasticitatea post AVC – diagnostic, management terapeutic, monitorizare (https://emc.formaremedicala.ro/cursuri-medicale/spasticitatea-post-avc-diagnostic-management-terapeutic-monitorizare/)
3. US National Library of Medicine, Post-Stroke Spasticity (https://www.ncbi.nlm.nih.gov/books/NBK585580/)
4 US National Library of Medicine, Early Identification, Intervention and Management of Post-stroke Spasticity: Expert Consensus Recommendations (https://pmc.ncbi.nlm.nih.gov/articles/PMC8461119/)
5. World Health Organisation. Stroke, Cerebrovascular accident (https://www.emro.who.int/health-topics/stroke-cerebrovascular-accident/index.html)
