News And Notes

Survey Highlights Impact of Post-Stroke Spasticity

IRVINE, CA -- Seventy percent of stroke survivors living with spasticity and their caregivers rank the debilitating condition as one of the top three symptoms impacting their life post-stroke, according to a recent survey conducted by Allergan Inc. and the National Stroke Association.

Spasticity, which causes muscles to contract and spasm, causing stiffness and pain, ranks second only to paralysis in its impact, yet close to 50 percent of stroke survivors and their caregivers are unaware of the available treatment options.

Stroke is the leading cause of serious, long-term disability in the United States. Today, there are approximately seven million stroke survivors in this country. According to a survey of stroke survivors and their primary caregivers, approximately 60 percent (n=504) of stroke survivors live with spasticity. Many may have upper limb spasticity. Upper limb spasticity, which affects the elbow, wrist and fingers, can present as a bent wrist with fingers pointing downward, a fist that stays clenched, or a flexed elbow that stays twisted against the chest.

"Spasticity significantly impacts the daily routines of both stroke survivors and their caregivers," said Jim Baranski, CEO of the National Stroke Association. "People living with upper limb spasticity often are not able to do the simplest of tasks like getting dressed, hand washing, or even eating. They grow dependent on their loved ones for help with these basic tasks. It's important for stroke survivors and their caregivers to know that spasticity is a very real medical condition and they should talk with their physician to get help."

Spasticity can occur weeks, months or even years after a stroke, possibly after a patient has stopped seeing a physician for follow-up care. Spasticity continues to be under-recognized and inadequately managed, according to a release.

Although more than 95 percent of the physicians surveyed believe spasticity has a moderate to severe impact on their patients' lives, 31 percent of neurologists and 27 percent of primary care physicians focus on preventing a secondary stroke, and 22 percent of neurologists and 26 percent of primary care givers focus on managing acute needs when treating stroke survivors. Physical therapists and physiatrists, on the other hand, are much more focused on helping manage the after-effects of a stroke, with 22 percent of PM&R physicians and 38 percent of physical therapists reporting that their focus in the first six months of a stroke patient's follow-up care is on understanding and discussing physical complications such as spasticity.

"It is critical for physicians to address spasticity with their post-stroke patients at the onset of, and throughout, their follow-up care," said Dr. Elliot J. Roth, medical director of the Patient Recovery Unit and attending physician, Rehabilitation Institute of Chicago, and professor and chair of PM&R at Northwestern University Feinberg School of Medicine. "Spasticity is a disabling condition, but, oftentimes, patients are either uncomfortable or too overwhelmed to discuss it with their physician. The focus after someone has experienced a stroke is so commonly on preventing a second stroke, that rehabilitation goals are covered in broad terms. This can leave patients and their caregivers feeling unprepared for a larger discussion about the post-stroke symptoms they may be experiencing, including spasticity. It's critical that patients and caregivers understand that even if a person has been experiencing spasticity for years, in many cases there are ways to help manage the condition."


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