Enhancing patient–provider communication for long-term post-stroke spasticity management


  • K. S. Sunnerhagen,

    Corresponding author
    • The Institute of Neuroscience and Physiology – Section for Clinical Neuroscience and Rehabilitation, Gothenburg University, Göteborg, Sweden
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  • G. E. Francisco

    1. Department of Physical Medicine and Rehabilitation, The University of Texas Health Science Center at Houston, TIRR Memorial Hermann, Houston, TX, USA
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K. S. Sunnerhagen, Institute of Neuroscience and Physiology, Section for Clinical Neuroscience and Rehabilitation, The Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden.

Tel: +46-31-342-2803

Fax: +46-31-342-2467

e-mail: KS.Sunnerhagen@neuro.gu.se.


Stroke is a major public health concern, with estimated 16 million people worldwide experiencing first-time strokes each year, a number that is expected to rise. Two-thirds of those experiencing a stroke are younger than 70 years of age. Stroke is a leading cause of disability in adults as a result of major sequelae that include spasticity, cognitive impairment, paresis, and depression. Disabling spasticity, defined as spasticity severe enough to require intervention, occurs in 4% of stroke survivors within 1 year of first-time stroke. The aim of this report is to focus instead on a discussion of patient–provider communication, and its role in post-stroke spasticity (PSS) rehabilitation within the context of patient-centered health care. A discussion based on a review of the literature, mainly since 2000. Problems within communication are identified and suggestion to enhance communication are proposed thus improving patient-centered goal setting/goal achievement for the effective management of spasticity rehabilitation. These are as follows: (i) involving family members, (ii) educating patients and family members on stroke and rehabilitation, and (iii) establishing a common definition for long-term goals. Increased communication among physicians, patients, and payers may bridge some of the gaps and increase the effectiveness of PSS rehabilitation and management.