HUBUNGAN SPASTISITAS DENGAN NYERI PASCA STROKE

Astuti Tjondronegoro, dr. Damodoro Nuradyo, Sp. S(K)

2013 | Tesis | S2 Ilmu Penyakit Saraf

Nyeri sangat umum dijumpai pasca stroke. Nyeri pasca stroke dapat terjadi sebagai akibat langsung lesi di otak, immobilitas, sekuele stroke atau akibat terapi stroke. Sampai saat ini, studi yang meneliti hubungan spastisitas dengan nyeri pasca stroke masih terbatas. Tujuan penelitian ini yaitu untuk mengetahui hubungan spastisitas dengan nyeri pasca stroke. Metode penelitian menggunakan potong lintang. Delapan puluh pasien pasca stroke diperiksa, selanjutnya dibagi dalam dua kelompok yaitu kelompok dengan spastisitas dan kelompok tanpa spastisitas. Intensitas nyeri diukur dengan visual analogue scale (VAS), sedangkan spastisitas menggunakan modified modified ashworth scale (MMAS). Nyeri pasca stroke terjadi pada 45 subjek penelitian dengan rerata VAS 3,57. Hasil analisis univariat menunjukkan bahwa terdapat hubungan antara nyeri pasca stroke dengan spastisitas, defisit sensorik dan motorik. Hasil analisis regresi logistik menunjukkan bahwa spastisitas (95% CI; p=0.001; RP=8.238) dan defisit sensorik (95% CI; p=0.012; RP=4.324) merupakan variabel independent yang berhubungan langsung dengan nyeri pasca stroke. Simpulan penelitian ini adalah spastisitas berhubungan dengan nyeri pasca stroke. Semakin berat spastisitas maka semakin tinggi intensitas nyeri pasca stroke.

Pain is particularly common after stroke. Post-stroke pain can arise as a direct consequence of the brain itself, from the ensuing disabilities or immobility, or from stroke-related treatments. At present, there is little evidence for the association between post-stroke pain and spasticity. The aim of this study is to acknowledge the association of spasticity with post-stroke pain. This is a cross-sectional study. Eighty post-stroke patients were examined and divided into two groups, 40 subjects in spasticity group and the others without spasticity. We measured pain intensity with visual analogue scale (VAS), meanwhile the assessment of spasticity using modified modified ashworth scale (MMAS). Pain was reported by 45 patients with mean VAS 3,57. Univariate analysis demonstrated association between post-stroke pain and spasticity, motor and sensory deficites. A logistic regression analysis demonstrated that spasticity (95% CI; p=0.001; RP=8.238) and sensory deficit (95% CI; p=0.012; RP=4.324) were the only independent variables that significantly increased risk of post-stroke pain. The conclusion of this study is that spasticity related to post-stroke pain. The more severe of spasticity, the higher intensity of post-stroke pain.

Kata Kunci : nyeri pasca stroke, spastisitas, stroke, VAS, MMAS