Perception of lower limb spasticity in patients with spinal cord injury.
METHODS
Cross-sectional study.


OBJECTIVE
To study the manifestation of spasticity in daily life of the patients with spinal cord injury, their perception of spasticity and spasticity-related discomfort.


METHODS
Rehabilitation center in the Netherlands.


METHODS
Twenty-six patients with motor complete spinal cord injury (SCI) and spasticity in the lower limbs completed a questionnaire. The following outcome measures were used: manifestation of spasticity, activities during which spasticity occurs, perceived degree of spasticity and resulting discomfort, measured with visual analog scale (VAS) and Borg scale, respectively.


RESULTS
In general, spasticity manifested as extensor spasms (84.6%), flexor spasms and/or clonus (both 69.2%), and less often as continuous tension (57.7%). The registered activities were categorized into five main groups: 'changing position' was the largest group (22.0%) with a median VAS of 6.8 (range: 2.5-9.5) and median Borg scale of 3.0 (range: 1.0-7.0). Other groups of activities were 'making a transfer' (20.7%), 'activities of daily living' (17.1%), 'being active' (17.1%) and 'stable body position' (12.2%). The overall correlation between VAS and Borg was moderate (Spearman's rho=0.53, P=0.005).


CONCLUSIONS
Patients with complete SCI experienced several manifestations of spasticity, extensor spasms being the most common. Many daily life activities elicited different manifestations of spasticity. The experienced discomfort was only moderately related to the perceived degree of spasticity during an activity. Possibly, the discomfort is influenced by other factors than the perceived spasticity alone.
Fleuren
J F
JF
Roessingh Research and Development, Enschede, The Netherlands. j.fleuren@rrd.nl
Voerman
G E
GE
Snoek
G J
GJ
Nene
A V
AV
Rietman
J S
JS
Hermens
H J
HJ
D000203:Activities of Daily Living / Q000523:psychology*; D000328:Adult; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007866:Leg / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009128:Muscle Spasticity / Q000503:physiopathology* / Q000534:rehabilitation; D009426:Netherlands; D009460:Neurologic Examination / Q000379:methods; D012720:Severity of Illness Index; D013119:Spinal Cord Injuries / Q000150:complications* / Q000503:physiopathology* / Q000534:rehabilitation; D011795:Surveys and Questionnaires