title: Dynamometer-based measure of spasticity confirms limited association between plantarflexor spasticity and walking function in persons with multiple sclerosis.
abstract: The literature shows inconsistent evidence regarding the association between clinically assessed plantar-flexor (PF) spasticity and walking function in ambulatory persons with multiple sclerosis (pwMS). The use of a dynamometer-based spasticity measure (DSM) may help to clarify this association. Our cohort included 42 pwMS (27 female, 15 male; age: 42.9 +/- 10.1 yr) with mild clinical disability (Expanded Disability Status Scale score: 3.6 +/- 1.6). PF spasticity was assessed using a clinical measure, the modified Ashworth Scale (MAS), and an instrumented measure, the DSM. Walking function was assessed by the timed 25-foot walk test (T25FWT), the 6-minute walk test (6MWT), and the 12-item Multiple Sclerosis Walking Scale (MSWS-12). Spearman rho correlations were used to evaluate relationships between spasticity measures, measures of walking speed and endurance, and self-perceived limitations in walking. The correlation was small between PF spasticity and the T25FWT (PF maximum [Max] MAS rho = 0.27, PF Max DSM rho = 0.26), the 6MWT (PF Max MAS rho = -0.20, PF Max DSM rho = -0.21), and the MSWS-12 (PF Max MAS rho = 0.11, PF Max DSM rho = 0.26). Our results are similar to reports in other neurologic clinical populations, wherein spasticity has a limited association with walking dysfunction.
authors.affiliation: School of Medicine, Saint Louis University, St. Louis, MO;
authors.forename: Theodore R
authors.initials: TR
authors.lastname: Kremer
authors.forename: Linda R
authors.initials: LR
authors.lastname: Van Dillen
authors.forename: Joanne M
authors.initials: JM
authors.lastname: Wagner
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000534:rehabilitation*; D005260:Female; D005528:Foot / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications / Q000503:physiopathology* / Q000534:rehabilitation; D009128:Muscle Spasticity / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D053581:Muscle Strength Dynamometer; D016138:Walking / Q000502:physiology*; D055815:Young Adult
keywords: 12-item Multiple Sclerosis Walking Scale; ambulation; dynamometer; modified Ashworth Scale; multiple sclerosis; self-perceived limitations; spasticity; walking dysfunction; walking endurance; walking speed