Nowadays prevalence of stroke related spasticity is not studied enough. About 80 % of patients who have survived stroke have motor impairment of contralateral limbs, e.g. hemiparesis. Recent scientific research has shown that post-stroke spasticity occurs in 20–30 % of cases.

Damage to the pyramidal tract and its accompanying extrapyramidal fibers results in the upper motor neuron syndrome, which has positive and negative features. Negative components include spasticity and abnormal postures, characteristics that are not normally present; positive features include spasticity and abnormal postures, characteristics that are not normally present.

Very often spasticity impairs and gives discomfort for a person who has it. In that case it should be managed and relieved. There are a number of different scales and methods by which the degree of spasticity can be measured.

At the department of neuropathology and neurosurgery most frequently, we use the Modified Ashworth Scale, Tardieu Scale, Functional Independence Measure, Visual Analog Scale for Pain and some parameters from ENMG study (Hoffmann’s reflex and F/M max measured for ulnar nerve at the side of paresis).

24 patients with post-stroke spasticity were treated during 14 days using the same centrally acting anti-spastic drug (oral tolperisone hydrochloride, "Mydocalm"). The average duration of spasticity was 25 months (minimum 20 months and maximum 36 months). 24 patients were rated on the Modified Ashworth Scale and of those patients: 1 was rated stage "1", 5 – stage "1+", 7 – stage "2", 7 – stage "3" and 3 patients were rated stage "4". Assessment of muscle tone for each patient was performed daily during morning round.

The results were statistically analyzed through Microsoft Excel 2010 using Student’s method and Spearman’s rank correlation coefficient. P value less that 0,05 was considered as a significant level.

In comparison to the first day we observed statistically significant reduction in Hoffman’s reflex and parameters of F-wave for ulnar nerve starting on the third and second day respectively. For Visual Analog Scale for Pain we got statistically significant difference on the fourth day, in comparison to the first day. Muscle tone assessment scales (Modified Ashworth Scale and Tardieu Scale) has also shown positive dynamics, but statistically significant changes that were observed only started on the seventh day. No statistically significant changes were noted in measurement based on Functional Independence Measure (p > 0,05).

With the goal of determining whether there is a conection between the Modified Ashworth Scale and parameters of ENMG study (Hoffman’s reflex, H/Mmax) we used Spearman’s rank correlation coefficient. The greatest correlation (–0,34) was observed on the twelfth day of the treatment but was not statistically significant and therefore it is not feasible to map stages of spasticity according to the Modified Ashworth Scale to particular amount of increased measured by H/Mmax.

According to the collected statistics we can advice for controling treatment of poststroke spasticity using ENMG parameters and Visual Analog Scale for Pain during first 7 days of treatment, using of the Modified Ashworth Scale and Tardieu Scale is more appropriate starting on the 7th day of taking anti-spastic medications. Unfortunately, according to the gathered statistics there is no correlation between the Modified Ashworth Scale and parameters of ENMG.

Keywords: post-stroke spasticity, assessment of spasticity, electroneuromyographic assessment of spasticity

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