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The aim of the study was to investigate the correlation between spasticity severity and functional outcomes during the first year after stroke.The Korean Stroke Cohort for Functioning and Rehabilitation is a large, multicenter, prospective cohort study of all patients with acute first-ever stroke admitted to participating hospitals in nine Korean areas. To investigate the correlation between spasticity severity and functional status measured by using the Institutes of Health Stroke Scale (NIHSS), Modified Barthel Index (MBI), Functional Independence Measurement (FIM), Fugl-Meyer Assessment (FMA), Functional Ambulatory Category (FAC), modified Rankin scale (mRS), and American Speech-Language Hearing Association National Outcome Measurement System Swallowing Scale (ASHA-NOMS), data were analyzed at 3, 6, and 12 mos after the occurrence of stroke.A total of 7359 stroke patients, 3056 were finally included. Prevalence rates of spasticity in patients after stroke were 6.8% at 3 mos, 6.9% at 6 mos, and 7.6% at 12 mos. The scores of mRS and NIHSS were higher and those of K-MBI, FIM, FMA, and ASHA-NOMS were lower in more severe spastic patients, indicating poorer functional outcomes (P0.05).This study demonstrated the coexistence of spasticity and poor functional outcome during the first year after first-ever stroke patients.

Jo JM, Kim Y-H, Ko M-H, Ohn SH, Joen B, Lee KH: Enhancing the working memory of stroke patients using tDCS. Am J Phys Med Rehabil 2009;88: 404‐409. Objectives: We investigated whether anodal transcranial direct current stimulation over the left dorsolateral prefrontal cortex affected the working memory performance of patients after a stroke. Design: Ten patients (mean age 47.7 yrs) with cognitive deficits after a first-ever stroke participated in this single-blind, crossover, and shamcontrolled experiment. Each patient was randomly assigned to undergo two transcranial direct current stimulation sessions: anodal dorsolateral prefrontal cortex and sham stimulation within 48 hrs of a washout period. All participants performed a two-back working memory task before and after the administration of the transcranial direct current stimulation. Accuracy (correction rate), recognition accuracy (correction rate-commission error rate), and response time were measured during each experiment. Results: Repeated-measures analysis of variance indicated a significant interaction effect of transcranial direct current stimulation type and time on the recognition accuracy. Post hoc analyses revealed a significant difference between prestimulation and poststimulation in the anodal stimulation group but not in the sham stimulation group. Regarding the accuracy, the paired t test indicated significant improvement only after anodal transcranial direct current stimulation without a significant interaction effect between the two transcranial direct current stimulation types. The response time was not significantly different in the anodal and sham stimulation groups. Conclusion: Our results demonstrated that anodal transcranial direct current stimulation over the left dorsolateral prefrontal cortex was associated with enhanced working memory performance as indexed by the recognition accuracy in patients after a stroke.