Abstract
Objective
To characterize the qualities that individuals with spinal cord injury (SCI) associate
with their experience of spasticity and to describe the relationship between spasticity
and perceived quality of life and the perceived value of spasticity management approaches.
Design
Online cross-sectional survey.
Setting
Multicenter collaboration among 6 Spinal Cord Injury Model Systems hospitals in the
United States.
Participants
Individuals with SCI (N=1076).
Interventions
Not applicable.
Main Outcome Measures
Qualities of Spasticity Questionnaire, modified Spinal Cord Injury–Spasticity Evaluation
Tool (mSCI-SET), and the modified Patient-Reported Impact of Spasticity Measure (mPRISM).
Results
Respondents indicated that spasms most often occurred in response to movement-related
triggering events. However, spontaneous spasms (ie, no triggering event) were also
reported to be among the most common types. Frequency of spasms appears to decline
with age. The highest frequency of spasms was reported by 56% of respondents aged
<25 years and by only 28% of those >55 years. Stiffness associated with spasticity
was reported to be more common than spasms (legs, 65% vs 54%; trunk, 33% vs 18%; arms,
26% vs 15%). Respondents reported negative effects of spasticity more commonly than
positive effects. Based on their association with negative scores on the mSCI-SET
and the mPRISM, the 5 most problematic experiences reported were stiffness all day,
interference with sleep, painful spasms, perceived link between spasticity and pain,
and intensification of pain before a spasm. Respondents indicated spasticity was improved
more by stretching (48%) and exercise (45%) than by antispasmodics (38%).
Conclusions
The experience of spasticity after SCI is complex and multidimensional, with consequences
that affect mobility, sleep, comfort, and quality of life. Stiffness, rather than
spasms, appears to be the most problematic characteristic of spasticity. Physical
therapeutic interventions to treat spasticity warrant in-depth investigation.
Keywords
List of abbreviations:
mPRISM (modified Patient-Reported Impact of Spasticity Measure), mSCI-SET (modified Spinal Cord Injury–Spasticity Evaluation Tool), PRISM (Patient-Reported Impact of Spasticity Measure), QOL (quality of life), SCI (spinal cord injury), SCI-SET (Spinal Cord Injury-Spasticity Evaluation Tool)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: May 17, 2021
Accepted:
March 23,
2021
Received in revised form:
January 14,
2021
Received:
October 14,
2020
Footnotes
Presented to the Society for Neuroscience, October 19-23, 2019, Chicago, IL; the International Spinal Cord Society, November 5-7, 2019, Nice, France; and the American Physical Therapy Association, Denver, CO, February 12-15, 2020.
Supported by the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR, grant no. 90SI5016). NIDILRR is a Center within the Administration for Community Living (ACL), Department of Health and Human Services (HHS). The contents of this article do not necessarily represent the policy of NIDILRR, ACL, or HHS, and you should not assume endorsement by the Federal Government.
Disclosures: none.
Identification
Copyright
© 2021 The American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
