Deans' stroke musings: Early Recognition and Intervention for Poststroke Spasticity: A Scientific Statement From the American Heart Association

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Saturday, January 31, 2026

Early Recognition and Intervention for Poststroke Spasticity: A Scientific Statement From the American Heart Association

WOW! And you think this does anything at all to get spasticity cured? You're fucking delusional!

I will against my better nature hope all of you discover schadenfreude when you have spasticity and DON'T RECOVER!

Early Recognition and Intervention for Poststroke Spasticity: A Scientific Statement From the American Heart Association

Sujani Bandela, MD, Vice Chair,

Laura McPherson, DPT, PhD,

Richard L. Harvey, MD, FAHA,

Oluwole Awosika, MD,

Dipika Aggarwal, MD,

Charles Y. Liu, MD,

Preeti Raghavan, MD, FAHA, and

Mark P. Goldberg, MD, FAHA, Chair on behalf of the American Heart Association Stroke Council; Council on Cardiovascular and Stroke Nursing; Council on Basic Cardiovascular Sciences; Council on Lifestyle and Cardiometabolic HealthAuthor Info & Affiliations

Stroke

New online

https://doi.org/10.1161/STR.0000000000000515

Abstract

Spasticity and related motor disorders are common and often disabling complications after stroke, affecting an estimated 30% to 80% of survivors. Spasticity can impair functional mobility, reduce independence, and increase caregiver burden. Secondary complications, including pain, restricted range of motion, skin breakdown, and joint contractures, further degrade quality of life, limit rehabilitation outcomes, and increase health care costs. Despite the availability of options to manage spasticity and mitigate its effects, timely diagnosis and intervention remain key challenges. Many patients receive treatment only after spasticity has become well established, and others receive no treatment at all due to persistent disparities in recognition, access, and delivery of treatment for spasticity, contributing to long-term disability and increased costs of care(NOT RECOVERY!). This scientific statement reviews the rationale, established and emerging evidence, and strategic approaches for improving early recognition and intervention for poststroke spasticity. Early intervention is defined as treatment initiated within the first 3 months after stroke onset, potentially before development of secondary impairment from poorly controlled spasticity. Recognizing spasticity as a multidomain clinical syndrome—including involuntary muscle overactivity, impaired voluntary motor control, and passive tissue remodeling—offers important opportunities to improve timely diagnosis and treatment. Progress will also depend on a deeper understanding of the time course and pathophysiology of spasticity through both animal and human models. This scientific statement also outlines strategies to close gaps in recognition and care(NOT RECOVERY!), including expanding and training the specialist workforce; developing innovative, scalable approaches for early detection and management; and strengthening care(NOT RECOVERY!) pathways and access to meet the substantial unmet needs of patients with poststroke spasticity.

Spasticity is a common and often debilitating consequence of stroke, affecting an estimated 25% to 80% of survivors.1–6 This translates to ≈1.8 to 5.6 million stroke survivors in the United States alone. Globally, spasticity is estimated to affect >100 million individuals after stroke.6 Poststroke spasticity substantially affects functional recovery, quality of life, and long-term independence.5

The 2016 American Heart Association/American Stroke Association guidelines for adult stroke rehabilitation and recovery note that the cost of care(NOT RECOVERY!) is 4 times higher when spasticity is present and suggests approaches for recognition and treatment of spasticity.7 Nevertheless, spasticity remains underrecognized and undertreated. For many patients, this results in prolonged disability and the emergence of preventable secondary complications, which increases overall health care(NOT RECOVERY!) costs.2

The optimal timing for initiation of spasticity-related interventions is a crucial yet unresolved aspect of poststroke care(NOT RECOVERY!). For the purposes of this scientific statement, early intervention refers to treatment initiated within the first 3 months after stroke onset. The 3-month time window is consistent with previous studies of early spasticity intervention,8,9 and is not meant to exclude treatment approaches that might be initiated earlier in the poststroke course.

This scientific statement provides an overview of the current landscape of the diagnosis and management of poststroke spasticity, reviews the rationale for and available evidence supporting early treatment, and outlines future opportunities to reduce spasticity through early rehabilitative approaches. We identify key strategies to improve timely spasticity care(NOT RECOVERY!) by increasing awareness among patients and health care professionals to facilitate early recognition of risks and symptoms, and developing cost-effective, scalable models to improve access to care(NOT RECOVERY!), especially for high-risk individuals. Addressing these challenges will be essential for improving outcomes for the millions of people with poststroke spasticity.