Table 1.
Characteristics of included studies in meta-analysis.
| Study | Study design | Country | Sample | Stroke | Spasticity definition | Spasticity events | Predictors | Follow-up | Quality |
|---|---|---|---|---|---|---|---|---|---|
| Volny et al. (51) | Prospective cohort study | Czech | 76 | First ever ischemic stroke | MAS > 1 | 44 | Age, gender, baseline NIHSS, ASPECTS, location | 6 months | 6 |
| Shin et al. (49) | Prospective cohort study | Korea | 3056 | First ever stroke | MAS ≥ 1 | 3, 6, 12 months: 156, 153, 160 | Age, gender, stroke type, | 12 months | 7 |
| Katoozian et al. (34) | Prospective cohort study | Iran | 149 | First ever stroke with hemiplegia | MAS ≥ 1 | 1 week: 26 1 month: 30; 3 months: 18 |
Age, gender, stroke type, sensory disorder, lesion site | 3 months | 6 |
| Opheim et al. (41, 42) | Prospective cohort study | Sweden | 117 | First ever stroke with arm paresis | MAS ≥ 1 | 4 weeks: 48 12 months: 35 |
Age, sensation, paresis, early increase in muscle tone, OCSP, FMA | 12 months | 8 |
| Kong et al. (36) | Prospective cohort study | Singapore | 163 | First-ever ischemic stroke with weakness | MAS ≥ 1 Severe PSS:MAS ≥ 3 | 3, 6, 12months: 54, 67, 72 | UEMI, MBI | 12 months | 5 |
| Lundström et al. (30) | Prospective cohort study | Sweden | 50 | First-ever stroke with paresis | MAS ≥ 1 Disabling spasticity | 1 month: 13 6 months: 6 |
Severe arm paresis, sensory disorder | 6 months | 7 |
| Persson et al. (43) | Prospective cohort study | Sweden | 288 | First-ever or recurrent acute ischemic stroke | MAS ≥ 2 | 99 | Age, arm motor power | 7 years | 7 |
| Li et al. (54) | Prospective cohort study | China | 185 | ischemic stroke | MAS ≥ 1 Severe PSS:MAS ≥ 3 | 32 | Age, gender, sensory, smoking, diabetes, BI, lesion site, hypertension | 6 months | 6 |
| Urban et al. (46) | Prospective cohort study | Germany | 211 | First-ever ischemic stroke with paresis | MAS > 1 Severe PSS:MAS ≥ 3 | 90 | Severe paresis and hemi-hypesthesia at stroke onset, moderate paresis, mild paresis | 6 months | 9 |
| Leathley et al. (38) Watkins et al. (52) |
Cohort study | UK | 106 | Stroke | MAS ≥ 1 | 38 | Leg and arm weakness, BI, smoking, side of weakness | 12 months | 7 |
| Ryu et al. (48) | Retrospective cohort study | Korea | 245 | stroke | MAS ≥ 1 Severe PSS:MAS ≥ 3 | 104 | NIHSS, Motricity index | No reported | 5 |
| de Jong et al. (28) | Prospective cohort Study | Netherlands | 50 | Ischemic stroke and paralysis | MAS ≥ 1+ | 3 months: 23 6 months: 26 |
FMA, stroke duration | 6 months | 6 |
| Dornák et al. (29) | Prospective cohort study | Czech | 307 | First stroke with motor deficit | MAS > 1 Severe PSS:MAS ≥ 3 | 138 | BI, mRS | 12 months | 8 |
| van Kuijk et al. (50) | Cohort study | Netherlands | 43 | Ischemic stroke with paralysis | AS ≥ 2 | 22 | Sensory disorder, early hand motor recovery | 26 weeks | 7 |
| Plantin et al. (45) | Cohort study | Sweden | 61 | First ever stroke with weakness | Neuro Flexor | 3 weeks: 20; 3, 6 months: 28 | corticospinal tract damage, FMA-hand, lesion Volume | 6 months | 6 |
| Jin et al. (33) | Cohort study | China | 407 | First ever ischemic stroke | MAS > 1 | 3, 6, 12 months: 142, 163, 173 | Stroke site | 12 months | 6 |
| Picelli et al. (24) | Retrospective cohort study | Italy | 72 | Ischemic stroke hemiparesis | Severe PSS:MAS ≥ 3 | 40 | Age, gender, ESS foot, ESS arm (proximal paresis of upper limb and distal paresis of lower limb), smoking | 6 months | 7 |
| Egen-Lappe et al. (31) | Cohort study | Germany | 1167 | Stroke | Diagnosis code | 119 | Age, gender, hypertension, diabetes, stroke type | 6 months | 6 |
| Wissel et al. (32) | Prospective cohort study | Germany | 94 | Stroke | MAS ≥ 1 | 6 days: 23; 6, 16 weeks: 23,18 | Paresis, lower BI score, early increase in muscle tone | 16 weeks | 6 |
| Welmer et al. (53) | Prospective cohort study | Sweden | 109 | First-ever stroke | MAS > 0 | 3 months: 18 18 months: 13 |
No reported | 18 months | 6 |
ASPECTS, the Alberta Stroke Program Early CT Score; BI, Barthel Index; ESS, European Stroke Scale; NIHSS, National Institute of Health stroke scale; MBI, Modified Barthel Index; FMA, the Fugl-Meyer Assessment; mRS, modified Rankin scale; FMA-UE, the Fugl-Meyer Assessment Upper Extremity Scale; MAS, the Modified Ashworth Scale; AS, the Ashworth Scale; PSS, Poststroke spasticity; UEMI, Upper Extremity Motricity Index; OCSP, Oxfordshire community stroke project.