Francois Bethoux1, Ruth Ann Marrie2. 1. The Mellen Center for MS Treatment and Research, The Cleveland Clinic, 9500 Euclid Avenue/Desk U10, Cleveland, OH, 44195, USA. bethouf@ccf.org. 2. Medicine and Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
Abstract
BACKGROUND: Spasticity is frequently reported by patients with multiple sclerosis (MS). A previously published survey of participants in the North American Research Committee on Multiple Sclerosis (NARCOMS) registry showed that higher levels of spasticity were associated with higher MS-related disability and lower quality of life, but did not investigate the impact of spasticity on daily activities, and only partially assessed spasticity management. METHODS: A new cross-sectional survey was distributed to 15,679 eligible NARCOMS participants. We inquired about the degree of bother from symptoms associated with spasticity, interference with a variety of daily activities, as well as past and current treatments for spasticity. RESULTS: Among the 10,353 responders (66 % response rate), over 80 % reported experiencing spasticity, and more than 35 % were moderately or greatly bothered by stiffness, spasms, or pain, predominantly in the lower extremities. More severe spasticity was associated with worse disability, mobility, bladder function, and fatigue. Spasticity was most frequently reported to interfere with stair climbing, walking, and sleep. Most individuals reported receiving treatment for spasticity (mainly oral medications, stretching, home exercise, and physical therapy), yet fewer than half reported being satisfied with their current treatment. CONCLUSION: Spasticity was reported by a large majority of patients with MS, and found to interfere with many daily activities. At the same time, patients were often dissatisfied with the effects of treatments for spasticity. Prospective studies are needed to better characterize the impact of spasticity in individuals with MS, and to optimize treatment strategies.
BACKGROUND:Spasticity is frequently reported by patients with multiple sclerosis (MS). A previously published survey of participants in the North American Research Committee on Multiple Sclerosis (NARCOMS) registry showed that higher levels of spasticity were associated with higher MS-related disability and lower quality of life, but did not investigate the impact of spasticity on daily activities, and only partially assessed spasticity management. METHODS: A new cross-sectional survey was distributed to 15,679 eligible NARCOMS participants. We inquired about the degree of bother from symptoms associated with spasticity, interference with a variety of daily activities, as well as past and current treatments for spasticity. RESULTS: Among the 10,353 responders (66 % response rate), over 80 % reported experiencing spasticity, and more than 35 % were moderately or greatly bothered by stiffness, spasms, or pain, predominantly in the lower extremities. More severe spasticity was associated with worse disability, mobility, bladder function, and fatigue. Spasticity was most frequently reported to interfere with stair climbing, walking, and sleep. Most individuals reported receiving treatment for spasticity (mainly oral medications, stretching, home exercise, and physical therapy), yet fewer than half reported being satisfied with their current treatment. CONCLUSION:Spasticity was reported by a large majority of patients with MS, and found to interfere with many daily activities. At the same time, patients were often dissatisfied with the effects of treatments for spasticity. Prospective studies are needed to better characterize the impact of spasticity in individuals with MS, and to optimize treatment strategies.
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