A Simple Bedside Grading Scale Can Effectively Predict Severe Post-Stroke Upper-Extremity Spasticity (P3.297)

Objective: This study aims to identify a bedside grading scale with the information collected in the acute stroke phase to predict upper-extremity spasticity at 3 months. Background: Upper-extremity spasticity is a disabling complication after stroke; however, there is no clinical standard grading scale to predict spasticity. Methods: This is a prospective cohort study of 44 patients with first-ever acute ischemic strokes with various degrees of motor impairment. Modified Ashworth Spasticity Scale (MASS) was used as a clinical assessment tool for spasticity assessment with biceps, wrist and finger flexors at 90 days (± 14 days). The highest value was used and severe spasticity is defined as MASS>=3. NIH Stroke Scale (NIHSS) is assessed between 2 to 5 days after stroke and 90 days (± 14 days) after stroke. Infarction volume was measured based on the lesion on MRI/DWI. Independent predictors of upper-extremity spasticity at days were identified by logistic regression. A risk stratification scale was developed with weighting of independent predictors based on strength of association. Results: Factors independently associated with upper-extremity spasticity are NIHSS Arm score at baseline (p =20 cc (1 point), <20cc (0 point). None of 12 patients with score of 0 (0[percnt]) and 9 out of 10 patients with score of 3 (90[percnt]) developed severe spasticity. The likelihood of developing severe upper-extremity spasticity increases steadily with grading scale score. Conclusion: A simple bedside grading scale can predict severe post-stroke upper-extremity spasticity at 90 days. It needs validation from another cohort. Disclosure: Dr. Feng has nothing to disclose. Dr. Bayona has nothing to disclose. Dr. Kautz has nothing to disclose. Dr. Chhatbar has nothing to disclose.