Does Spasticity Correlate With Motor Impairment in the Upper and Lower Limbs in Ambulatory Chronic Stroke Survivors?
Sheng Li, Jaskiran Ghuman, Javier Gonzalez-Buonomo and 6 others
PMID 37026840WHAT IT FOUND
In ambulatory chronic stroke survivors, upper limb spasticity correlated with greater motor impairment and weaker grip strength.
Lower limb spasticity did not correlate with motor impairment or gait speed. Clinicians may need to prioritize weakness over spasticity when addressing lower limb walking function.
Key findings
01Upper limb spasticity was moderately correlated with upper limb motor impairment and showed a negative correlation with grip strength.
02Lower limb spasticity showed no correlation with lower limb motor impairment or gait performance after adjusting for other factors.
03A large majority of participants used ankle foot orthoses, which may have masked the impact of lower limb spasticity on walking.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study included only 28 participants, which limits the ability to detect weak correlations. Most participants used ankle foot orthoses during gait testing, which may have reduced the observable impact of lower limb spasticity on walking. The study was exploratory and did not adjust for multiple testing, increasing the risk of false positive findings. Participants were in the chronic phase, so findings may not apply to acute or subacute stroke recovery. Motor synergies were not quantitatively analyzed, despite being a key factor in movement.
Declared interests
The authors declared no conflicts of interest. The study was supported by the National Institutes of Health.
The easy way to misread this
Do not conclude that lower limb spasticity never affects walking. The lack of correlation in this study may be due to the high use of ankle foot orthoses, which can compensate for spasticity, and the small sample size.