Stroke and spasticity: a comprehensive approach from the acute phase to rehabilitation

The study comprehensively addressed cerebrovascular disease and spasticity as one of its main neurological sequelae, highlighting its impact on the functionality and quality of life of those affected. Stroke was described as one of the leading causes of morbidity, mortality, and disability worldwide, with acute clinical manifestations requiring early diagnosis and management to optimise prognosis. The different types of stroke, both ischaemic and haemorrhagic, were reviewed, along with their pathophysiological mechanisms, risk factors, clinical manifestations and progression, emphasising the importance of acute care and secondary prevention. Spasticity is a common complication following stroke, associated with upper motor neuron lesions and maladaptive neuroplastic changes. Its pathophysiological mechanisms, clinical characteristics, classification, and relationship to pain, movement limitation, and functional disability were discussed. The paper highlighted the importance of early recognition of spasticity and identification of predictive factors for its appropriate management. The fundamental role of early and continuous neurological rehabilitation was emphasised, noting that it contributed significantly to reducing complications, improving functional autonomy and promoting the patient's social reintegration. Various therapeutic strategies were described, including physiotherapy, motor re-education, electrotherapy, neurophysiological methods and pharmacological and surgical management of spasticity. Finally, it was concluded that a multidisciplinary, individualised and evidence-based approach was essential to optimise functional recovery and quality of life after stroke.