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Relationship between self- and clinically rated spasticity in spinal cord injury.
Arch Phys Med Rehabil 2006; 87(1):15-9AP

Abstract

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+Show Affiliations

Institute for Clinical Research, Swiss Paraplegic Centre, Nottwil, Switzerland. helga.lechner@paranet.chNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

16401432

Citation

Lechner, Helga E., et al. "Relationship Between Self- and Clinically Rated Spasticity in Spinal Cord Injury." Archives of Physical Medicine and Rehabilitation, vol. 87, no. 1, 2006, pp. 15-9.
Lechner HE, Frotzler A, Eser P. Relationship between self- and clinically rated spasticity in spinal cord injury. Arch Phys Med Rehabil. 2006;87(1):15-9.
Lechner, H. E., Frotzler, A., & Eser, P. (2006). Relationship between self- and clinically rated spasticity in spinal cord injury. Archives of Physical Medicine and Rehabilitation, 87(1), pp. 15-9.
Lechner HE, Frotzler A, Eser P. Relationship Between Self- and Clinically Rated Spasticity in Spinal Cord Injury. Arch Phys Med Rehabil. 2006;87(1):15-9. PubMed PMID: 16401432.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Relationship between self- and clinically rated spasticity in spinal cord injury. AU - Lechner,Helga E, AU - Frotzler,Angela, AU - Eser,Prisca, PY - 2005/03/30/received PY - 2005/07/22/revised PY - 2005/07/28/accepted PY - 2006/1/13/pubmed PY - 2006/2/24/medline PY - 2006/1/13/entrez SP - 15 EP - 9 JF - Archives of physical medicine and rehabilitation JO - Arch Phys Med Rehabil VL - 87 IS - 1 N2 - 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. SN - 0003-9993 UR - https://www.unboundmedicine.com/medline/citation/16401432/Relationship_between_self__and_clinically_rated_spasticity_in_spinal_cord_injury_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0003-9993(05)01140-8 DB - PRIME DP - Unbound Medicine ER -