Prevalence and functional impact of self-reported joint stiffness after stroke: Results of a French national 'disability health' survey.

OBJECTIVE: The prevalence of joint stiffness following stroke is not known. Post-stroke spasticity is considered to be an important contributing factor to disability.

MATERIALS/PATIENTS AND METHODS: To evaluate the prevalence of joint stiffness in persons with a history of stroke in the whole French population, and the impact of joint stiffness on function.

METHODS: The "Disability Health" survey was carried out in people's homes (DHH) and in institutions (DHI) in France. Data regarding medical history and level of independence and disability, joint stiffness, motor deficit and medical and paramedical care were self-reported during face-to-face interviews. Persons under 18-year-old or in a vegetative state were excluded.

RESULTS: Of the 764,719 persons (SD=36,646) (adjusted data) who reported a history of stroke, 10.3% reported stroke-related stiffness. Participants who reported stiffness more frequently had a high Modified Rankin Score (above 2) (OR=2.18, CI 1.29-3.67), and were more frequently impaired with regard to climbing stairs, walking and grasping objects (P<0.01 for each). The frequency of severe disability (OR=1.181, CI=0.60-2.2) or impairment was no longer significant when the level of motor impairment was included in the multivariate analysis. There was no significant difference between the rate of consultation of a specialist doctor (PRM, neurologist or rheumatologist) between participants who reported stroke-related stiffness (23.1%) and those who did not report stroke-related stiffness (26.2%, P=0.576) DISCUSSION/CONCLUSION: Joint stiffness impacts functional capacity in patients with a history of stroke, however the degree of associated motor impairment remains one of the principal causes of disability.