Archives of Physical Medicine and Rehabilitation
Volume 80, Issue 12 , Pages 1548-1557, December 1999

Spasticity after traumatic spinal cord injury: Nature, severity, and location☆☆☆

  • Camilla Sköld, BS, PT

      Affiliations

    • Corresponding Author InformationReprint requests to Camilla Sköld, PT, Spinalis SCI Research Unit, Karolinska Institute, S-171 76 Stockholm, Sweden.
    • Department of Clinical Neuroscience and Occupational Therapy and Elderly Care Research Karolinska Institute, Stockholm, Sweden
    • Department of Physical Therapy Karolinska Institute, Stockholm, Sweden
    • Spinalis SCI Research Unit, Karolinska Institute, Stockholm, Sweden
    • ,
  • Richard Levi, MD, PhD

      Affiliations

    • Department of Physical Therapy Karolinska Institute, Stockholm, Sweden
    • Spinalis SCI Research Unit, Karolinska Institute, Stockholm, Sweden
    • ,
  • Åke Seiger, MD, PhD

      Affiliations

    • Department of Clinical Neuroscience and Occupational Therapy and Elderly Care Research Karolinska Institute, Stockholm, Sweden
    • Spinalis SCI Research Unit, Karolinska Institute, Stockholm, Sweden

Received 20 November 1998; accepted 28 April 1999.

Abstract 

Objective: To assess spasticity in a prevalence population of persons with traumatic spinal cord injury (SCI), and determine the degree of correspondence between self-reported spasticity and investigator-elicited spasticity using the modified Ashworth scale.

Design: Survey of a near total (88%) prevalence population.

Setting: Outpatient clinic of a university hospital.

Patients: A total of 354 individuals with SCI.

Main Outcome Measures: The survey includes self-reported symptoms, neurologic examination (American Spinal Injury Association [ASia]classification), physical therapy examination, range of motion (ROM), and complications.

Results: Presence of problematic spasticity was significantly correlated with cervical incomplete (ASIA B-D) injury. Reports of beneficial effects of spasticity were significantly less common in women. Self-reported problematic spasticity was significantly correlated with extensor spasticity. Spasticity was elicitable by movement provocation in 60% of the patients reporting spasticity. Significant correlations were found between elicitable spasticity and limited ROM.

Conclusion: Flexion, extension, and abduction movements performed with the patient placed in a standardized supine test position are suitable both for test of ROM and degree of spasticity. Spasticity was not elicitable by movement provocation on physical examination in 40% of the patients who reported spasticity, thus indicating that the patient's self-report is an important complement to the clinical assessment. A significant association between spasticity and contractures (reduced ROM) was seen.

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☆ Supported by grants from The Swedish Medical Research Council (14x-06555), The Karolinska Institute Committee for the Caring Sciences, The CTRF Foundation, The RTP Foundation, The Swedish Foundation for Healthcare Sciences and Allergy Research, and The Spinalis Foundation.

☆☆ No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors or upon any organization with which the authors are associated.

PII: S0003-9993(99)90329-5

Archives of Physical Medicine and Rehabilitation
Volume 80, Issue 12 , Pages 1548-1557, December 1999

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