Clinic-based severity and prevalence of contractures in stroke: a retrospective, cross-sectional observational study from the SPAstic REgistry.

Abstract

Myogenic contractures are a common consequence of stroke, yet their prevalence and severity remain unclear. This multicentred, retrospective, cross-sectional study assessed severity and prevalence of myogenic contractures in selected, clinically targeted upper- and lower-limb muscles using registry data and tested associations with spasticity severity, age, and disease duration. Data from 159 patients from specialised spasticity centres were analysed using first recorded muscle assessments at various time points post-stroke. Maximal passive muscle extensibility and spasticity were measured using the Tardieu Scale. Shoulder extensors, adductors, and thumb and finger flexors in the upper limb (22.0-35.7% shortening) and gastrocnemius, soleus, gluteus maximus, hamstrings, and rectus femoris in the lower limb (16.6-20.1%) were most affected. Mean contracture prevalence within selected, clinically targeted muscles was 90.9% within one year, with high proportions also observed at 1-10 years. Age and spasticity severity significantly correlated with contracture severity, while disease duration did not. This study provides clinic-based data on post-stroke myogenic contractures in selected, clinically targeted upper- and lower-limb muscles, highlighting high prevalence in these muscles. Shoulder extensors and adductors, along with plantar flexors, were most affected. The study emphasises the need for standardised contracture definition and measurement.