Spasticity is a part of the upper motor neuron syndrome and can result in reduced function. The impact of spasticity on poststroke recovery may not be obvious at first, and hence not addressed in the early phase. Spasticity in the upper limb spasticity has been found to be associated with reduced arm function and lower levels of independence, and with an astounding four-fold increase in direct care costs during the first-year poststroke [1, 2]. It seems as if spasticity in patients with stroke is more common in the upper extremity than in the lower limbs [3•], The frequency of spasticity in the upper limb varies from 7 % to 38 % [2, 4–6] in the first 12 months, and was found to be 46 % in patients with initial impaired arm function [7].

Early recognition of spasticity, and identification of predictors to assist rehabilitation professionals recognize which stroke patients are at risk for spasticity to develop, is suggested to yield earlier treatment of poststroke spasticity (PSS) and possibly better outcomes [8]. It would be helpful to know which factors can identify patients are at high risk of developing severe (PSS) especially during the initial admission poststroke. Increased knowledge regarding the pathophysiology, evolution of the condition, epidemiology, and therapeutic intervention for PSS, along with identifying PSS risk factors, is a road for better care [9].

The aim of this review is to present predictors that will help to identify which patients are at risk for the development of PSS.