The relationship of poststroke spasticity and motor recovery can be confusing. “True” motor recovery refers to return of motor behaviors to prestroke state with the same end-effectors and temporo-spatial pattern. This requires neural recovery and repair, and presumably occurs mainly in the acute and subacute stages. However, according to the International Classification of Functioning, Disability and Health, motor recovery after stroke is also defined as “improvement in performance of functional tasks,” i.e., functional recovery, which is mainly mediated by compensatory mechanisms. Therefore, stroke survivors can execute motor tasks in spite of disordered motor control and the presence of spasticity. Spasticity interferes with execution of normal motor behaviors (“true” motor recovery), throughout the evolution of stroke from acute to chronic stages. Spasticity reduction does not affect functional recovery in the acute and subacute stages; however, appropriate management of spasticity could lead to improvement of motor function, that is, functional recovery, during the chronic stage of stroke. We assert that spasticity results from upregulation of medial cortico-reticulo-spinal pathways that are disinhibited due to damage of the motor cortex or corticobulbar pathways. Spasticity emerges as a manifestation of maladaptive plasticity in the early stages of recovery and can persist into the chronic stage. It coexists and shares similar pathophysiological processes with related motor impairments, such as abnormal force control, muscle coactivation and motor synergies, and diffuse interlimb muscle activation. Accordingly, we propose a new definition of spasticity to better account for its pathophysiology and the complex nuances of different definitions of motor recovery.

中风后痉挛和运动恢复的关系可能令人困惑。“真正的”运动恢复是指运动行为恢复到具有相同末端执行器和时空模式的卒中前状态。这需要神经恢复和修复，并且可能主要发生在急性和亚急性阶段。然而，根据国际功能、残疾和健康分类，中风后的运动恢复也被定义为“功能任务表现的改善”，即功能恢复，主要由代偿机制介导。因此，尽管运动控制障碍和痉挛状态，中风幸存者仍可以执行运动任务。痉挛会干扰正常运动行为的执行（“真正的”运动恢复），在中风从急性到慢性的演变过程中。痉挛减轻不影响急性和亚急性期的功能恢复；然而，在中风的慢性阶段，适当的痉挛管理可以改善运动功能，即功能恢复。我们断言痉挛是由于运动皮层或皮质延髓通路受损而解除抑制的内侧皮质-网状-脊髓通路的上调所致。痉挛在恢复的早期阶段表现为适应不良的可塑性，并且可以持续到慢性阶段。它与相关的运动障碍共存并共享相似的病理生理过程，例如异常的力控制、肌肉共激活和运动协同作用以及弥漫性四肢间肌肉激活。因此，