Disclosures: Joerg Wissel, MD, FRCP:
Objective: To develop a tool to help identify patients at risk of developing post-stroke spasticity (PSS) and provide guidance on patient management
Design: Literature review and group discussion Setting : Working group discussion Participants : Experts specialising in spasticity management and stroke rehabilitation
Interventions: Not applicable
Main Outcome Measures: A review of published literature, in addition to extensive personal clinical experience, was used to identify known risk factors for PSS that were ordered by clinical severity. Published guidance was used to develop key referral pathways, advice and next steps for patient management following patient identification.
Results: Risk factors with a significant impact on the development of PSS were identified in the literature as increased muscle stiffness, loss of sensorimotor function, visual inattention, reduced mobility, lesion load in the corticospinal tract and general dexterity problems. Further potential risk factors included smoking, left-sided stroke and a manual occupation prior to stroke. The main risk factors were divided into three levels: urgent referral (red), routine referral (amber) and periodic monitoring (green). The tool was developed into an easy-to-use traffic light system for use in clinical practice and was further refined by a group of HCPs representative of the target audience. Conclusions: The PSS Risk Classification System was developed to support the identification of patients at risk of developing PSS and is recommended for use during post-stroke assessment within 12 weeks of the event, and at regular follow-up visits. Earlier diagnosis of PSS, with prompt referral to an appropriate specialist where required, may improve patient outcomes during stroke recovery.
Level of Evidence: Level II
To cite this abstract in AMA style:
Wissel J, Bavikatte G, Sposito MMdM, Picelli A, Winston P, Zuzek A. Development of an Early Identification Tool in Post-Stroke Spasticity (PSS): The PSS Risk Classification System [abstract]. PM R. 2020; 12(S1)(suppl 1). https://pmrjabstracts.org/abstract/development-of-an-early-identification-tool-in-post-stroke-spasticity-pss-the-pss-risk-classification-system/. Accessed June 28, 2025.« Back to AAPM&R Annual Assembly 2020
PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/development-of-an-early-identification-tool-in-post-stroke-spasticity-pss-the-pss-risk-classification-system/