OBJECTIVES: To assess the relation between self- and clinically rated spasticity in spinal cord injury (SCI) and to determine the extent to which symptoms like pain are included in the patients' self-rating of spasticity. DESIGN: Part 1: an observational, prospective, cross-sectional study and part 2: an observational, prospective, longitudinal study. SETTING: Swiss paraplegic center. PARTICIPANTS: Forty-seven (part 1) and 8 (part 2) persons with spastic SCI (American Spinal Injury Association grade A or B). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Clinical rating of movement-provoked spasticity using the Ashworth Scale; self-rating of general and present spasticity by the subject on a 4-point spasm severity scale and by using a visual analog scale (VAS); and questionnaires asking for antispasticity medication, impact of spasticity on daily life, body segment affected by spasticity, and symptoms associated with its occurrence. RESULTS: There was a poor correlation (rho=.36) between clinically rated (Ashworth Scale) spasticity and self-rated general spasticity and a modest correlation (rho=.70) between Ashworth Scale and self-rated present spasticity in the cross-sectional study in 47 subjects. Questionnaires showed that symptoms like pain and other sensations were associated by the patients with spasticity. There was a significant, but weak, correlation between VAS and Ashworth Scale in the longitudinal study in 3 of the 8 subjects and nonsignificant correlations in the remaining 5 subjects. CONCLUSIONS: A single clinical assessment of spasticity is a poor indication of a patient's general spasticity. Clinical measures of muscle tone-related spasticity should be complemented by self-rating that distinguishes muscle tone-related spasticity from spasticity affecting the sensory nervous system.
OBJECTIVES: To assess the relation between self- and clinically rated spasticity in spinal cord injury (SCI) and to determine the extent to which symptoms like pain are included in the patients' self-rating of spasticity. DESIGN: Part 1: an observational, prospective, cross-sectional study and part 2: an observational, prospective, longitudinal study. SETTING: Swiss paraplegic center. PARTICIPANTS: Forty-seven (part 1) and 8 (part 2) persons with spastic SCI (American Spinal Injury Association grade A or B). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Clinical rating of movement-provoked spasticity using the Ashworth Scale; self-rating of general and present spasticity by the subject on a 4-point spasm severity scale and by using a visual analog scale (VAS); and questionnaires asking for antispasticity medication, impact of spasticity on daily life, body segment affected by spasticity, and symptoms associated with its occurrence. RESULTS: There was a poor correlation (rho=.36) between clinically rated (Ashworth Scale) spasticity and self-rated general spasticity and a modest correlation (rho=.70) between Ashworth Scale and self-rated present spasticity in the cross-sectional study in 47 subjects. Questionnaires showed that symptoms like pain and other sensations were associated by the patients with spasticity. There was a significant, but weak, correlation between VAS and Ashworth Scale in the longitudinal study in 3 of the 8 subjects and nonsignificant correlations in the remaining 5 subjects. CONCLUSIONS: A single clinical assessment of spasticity is a poor indication of a patient's general spasticity. Clinical measures of muscle tone-related spasticity should be complemented by self-rating that distinguishes muscle tone-related spasticity from spasticity affecting the sensory nervous system.
Authors: João Carlos Correia de Sa; Laura Airas; Emmanuel Bartholome; Nikolaos Grigoriadis; Heinrich Mattle; Celia Oreja-Guevara; Jonathan O'Riordan; Finn Sellebjerg; Bruno Stankoff; Karl Vass; Agata Walczak; Heinz Wiendl; Bernd C Kieseier Journal: Ther Adv Neurol Disord Date: 2011-05 Impact factor: 6.570
Authors: Jacqueline Tibbett; Eva G Widerström-Noga; Christine K Thomas; Edelle C Field-Fote Journal: J Spinal Cord Med Date: 2018-01-15 Impact factor: 1.985
Authors: Patricia B Mills; Kaila A Holtz; Elena Szefer; Vanessa K Noonan; Brian K Kwon Journal: J Spinal Cord Med Date: 2018-10-09 Impact factor: 1.985