Characterizing the Experience of Spasticity after Spinal Cord Injury: A National Survey Project of the Spinal Cord Injury Model Systems Centers

Edelle C. Field-Fote, Catherine L. Furbish*, Natalie E. Tripp, Jeanne M. Zanca, Trevor Dyson-Hudson, Steven Kirshblum, Allen W. Heinemann, David Chen, Elizabeth Roy Felix, Lynn Worobey, Mary Schmidt-Read, Ralph J. Marino, Matthew J. Hayat

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)764-772.e2
JournalArchives of physical medicine and rehabilitation
Issue number4
StatePublished - Apr 2022


  • Hyperreflexia
  • Paralysis
  • Paraplegia
  • Patient reported outcome measures
  • Quadriplegia
  • Rehabilitation
  • Spasm

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation


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