Spasticity after traumatic spinal cord injury: nature, severity, and location.
OBJECTIVE
To assess spasticity in a prevalence population of persons with traumatic spinal cord injury (SCI), and determine the degree of correspondence between self-reported spasticity and investigator-elicited spasticity using the modified Ashworth scale.


METHODS
Survey of a near total (88%) prevalence population.


METHODS
Outpatient clinic of a university hospital.


METHODS
A total of 354 individuals with SCI.


METHODS
The survey includes self-reported symptoms, neurologic examination (American Spinal Injury Association [ASIA] classification), physical therapy examination, range of motion (ROM), and complications.


RESULTS
Presence of problematic spasticity was significantly correlated with cervical incomplete (ASIA B-D) injury. Reports of beneficial effects of spasticity were significantly less common in women. Self-reported problematic spasticity was significantly correlated with extensor spasticity. Spasticity was elicitable by movement provocation in 60% of the patients reporting spasticity. Significant correlations were found between elicitable spasticity and limited ROM.


CONCLUSIONS
Flexion, extension, and abduction movements performed with the patient placed in a standardized supine test position are suitable both for test of ROM and degree of spasticity. Spasticity was not elicitable by movement provocation on physical examination in 40% of the patients who reported spasticity, thus indicating that the patient's self-report is an important complement to the clinical assessment. A significant association between spasticity and contractures (reduced ROM) was seen.
Sköld
C
C
Department of Clinical Neuroscience and Occupational Therapy and Elderly Care Research, Karolinska Institute, Stockholm, Sweden.
Levi
R
R
Seiger
A
A
D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009128:Muscle Spasticity / Q000145:classification / Q000175:diagnosis* / Q000209:etiology* / Q000503:physiopathology / Q000534:rehabilitation; D009460:Neurologic Examination; D026741:Physical Therapy Modalities; D015995:Prevalence; D016059:Range of Motion, Articular; D012720:Severity of Illness Index; D013119:Spinal Cord Injuries / Q000150:complications*; D011795:Surveys and Questionnaires