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Arch Phys Med Rehabil. 2006 Jan;87(1):15-9.

Relationship between self- and clinically rated spasticity in spinal cord injury.

Author information

  • 1Institute for Clinical Research, Swiss Paraplegic Centre, Nottwil, Switzerland. helga.lechner@paranet.ch

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.

PMID:
16401432
[PubMed - indexed for MEDLINE]
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