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Arch Phys Med Rehabil. 1999 Dec;80(12):1548-57.

Spasticity after traumatic spinal cord injury: nature, severity, and location.

Author information

1
Department of Clinical Neuroscience and Occupational Therapy and Elderly Care Research, Karolinska Institute, Stockholm, Sweden.

Abstract

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.

DESIGN:

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

SETTING:

Outpatient clinic of a university hospital.

PATIENTS:

A total of 354 individuals with SCI.

MAIN OUTCOME MEASURES:

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.

CONCLUSION:

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.

PMID:
10597805
DOI:
10.1016/s0003-9993(99)90329-5
[Indexed for MEDLINE]

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