TY - JOUR
T1 - Characterizing the Experience of Spasticity after Spinal Cord Injury
T2 - A National Survey Project of the Spinal Cord Injury Model Systems Centers
AU - Field-Fote, Edelle C.
AU - Furbish, Catherine L.
AU - Tripp, Natalie E.
AU - Zanca, Jeanne M.
AU - Dyson-Hudson, Trevor
AU - Kirshblum, Steven
AU - Heinemann, Allen W.
AU - Chen, David
AU - Felix, Elizabeth Roy
AU - Worobey, Lynn
AU - Schmidt-Read, Mary
AU - Marino, Ralph J.
AU - Hayat, Matthew J.
N1 - Funding Information:
We thank the following individuals for their valuable contributions to the development of the survey: Spinal Cord Injury Model Systems Spasticity Module Collaborators Rachel Byrne, MA (Kessler Foundation), Diana Cardenas, MD (University of Miami), Rachel Cowan, PhD (University of Alabama, Birmingham), and Marilyn Owens, RN (Thomas Jefferson University). We are grateful to Kimberley Anderson, PhD (Case Western Reserve University) for her insightful comments. 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.
Funding Information:
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.
Publisher Copyright:
© 2021 The American Congress of Rehabilitation Medicine
PY - 2022/4
Y1 - 2022/4
N2 - 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.
AB - 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.
KW - Hyperreflexia
KW - Paralysis
KW - Paraplegia
KW - Patient reported outcome measures
KW - Quadriplegia
KW - Rehabilitation
KW - Spasm
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U2 - 10.1016/j.apmr.2021.03.040
DO - 10.1016/j.apmr.2021.03.040
M3 - Article
C2 - 34015348
AN - SCOPUS:85114745789
SN - 0003-9993
VL - 103
SP - 764-772.e2
JO - Archives of physical medicine and rehabilitation
JF - Archives of physical medicine and rehabilitation
IS - 4
ER -