Post Stroke Spasticity and Related Factors: A Systematic Review and Meta-analysis

Background and Post stroke spasticity has detrimental effects on quality of life and functions of patients. Moreover, it causes high economic and mental burden. Recognition of factors associated with spasticity can help in its treatment and prevention. The purpose of this study was to systematically review and meta-analysis of previously published studies concerning the prevalence of post stroke spasticity and its association with age, gender, type of stroke, and location of brain lesion. A literature review was conducted in studies published between 2000-2014 in PubMed, Science Direct, Scopus, Google scholar, and Springer Link databases. The following terms were used as. We obtained 769 articles of which 42 were chosen based on their titles. After studying the abstracts and full texts, only 16 were considered that were congruent with the inclusion criteria of our study. The association between spasticity and time, age, gender, type of stroke and location was considered in 9, 9, 9, 5, and 6 articles, respectively. According to these studies the incidence rates of post stroke spasticity were 4-27% earlier than 3 months, 19-42.6% between 3 and 6 months, and 20-38% after 6 months. The intensity of the spasticity increased over time. Gender and type of stroke were not found to be significantly associated with spasticity in any study. Findings about age were contradictory in different articles. There was a significant relationship between sever upper limb spasticity and subcortical lesions. However, involved lobes or circulation sites were not significantly associated with spasticity. Time has an important role on incidence and intensity alternations of post stroke spasticity.