Manejo de los síntomas asociados a la espasticidad en pacientes con esclerosis múltiple

Fernández-Pablos, María Asunción; Costa‐Frossard, Lucienne; García-Hernández, Carlos; García-Montes, Inmaculada; Escutia-Roig, Matilde

doi:10.1016/j.enfcli.2016.06.009

Cited by 3 publications

(5 citation statements)

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“…The largest clusters were of spasticity, spasms/cramps and pain, and the cluster of those three symptoms plus fatigue. Pain was the symptom most frequently associated with spasticity, as also found in other studies ( 14 , 20 ). In this study, pain was more common in RRMS patients but the difference was not statistically significant.…”

Section: Discussionsupporting

confidence: 87%

Spasticity-Plus syndrome in multiple sclerosis patients in a tertiary hospital in Spain

Goicochea Briceño,

Higueras,

Ruiz Pérez

et al. 2024

Front. Neurol.

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IntroductionSpasticity is a common symptom in multiple sclerosis (MS) and it is often associated with other symptoms such as spasms/cramps and pain. The concept of Spasticity-Plus syndrome takes into account that spasticity is accompanied by one or more symptoms (spasms/cramps, pain, bladder dysfunction, sleep disorders, fatigue and/or tremor). As these symptoms share a common cannabinoid control, therapy acting on cannabinoid receptors may be useful. The main study objectives were to determine the number of MS patients who met Spasticity-Plus syndrome criteria and to identify the most common symptoms.MethodsClinical records of MS patients treated with nabiximols in a tertiary hospital from 2002 to 2022 were reviewed retrospectively.ResultsOf the 73 patients included in the study, 53.4% were women, and most had secondary progressive MS (64.4%). All patients met the criteria for Spasticity-Plus syndrome: 100% had spasticity and at least another symptom. Pain was the second most common symptom (91.8%), followed by spasms/cramps (79.4%), and fatigue (76.7%). Sleep disturbances (p < 0.0001) and tremor (p < 0.027) were more frequent in patients with relapsing–remitting MS than in patients with progressive MS. No statistically significant differences were found for spasticity, pain, spasms/cramps, and fatigue between MS phenotypes. Regarding symptoms clusters, 94.4% of the patients had three or more symptoms. Spasticity was more frequently associated with pain (91.8%) and spasms/cramps (79.4%).ConclusionSpasticity-Plus syndrome was present in all the study population of patients with different MS phenotypes, and treated with nabiximols.

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Section: Discussionsupporting

confidence: 87%

Spasticity-Plus syndrome in multiple sclerosis patients in a tertiary hospital in Spain

Goicochea Briceño,

Higueras,

Ruiz Pérez

et al. 2024

Front. Neurol.

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“…In the last decade, specialist nurses have participated in clinical management and education of immunomodulatory therapies and are closer to pwMS lives. The creation of a structured interview may be a support strategy to systematically assess spasticity and related symptoms that may interfere with ADL, and promote educational awareness for pwMS (Crawford et al, 2014; Currie, 2001; Fernández‐Pablos et al, 2016; Jarrett, 2006).…”

Section: Discussionmentioning

confidence: 99%

“…• PwMS perceive spasticity as one of the most limiting symptoms for activities of daily living (ADL) and is associated with a worse perception of quality of life (QoL). (Fernández-Pablos et al, 2016;Saposnik et al, 2021). Importantly, they can capture the perception of their symptoms more closely.…”

Section: What This Paper Adds?mentioning

confidence: 99%

“…In addition to providing the usual care to pwMS, specialist nurses are in charge of coordinating care, providing specific medical education and being the reference of the medical team for solving doubts (Biswas et al, 2019; Mancini et al, 2020). Their role in the diagnosis and clinical approach to symptoms may not be completely developed yet, but there is growing evidence that their behavioural characteristics may influence the management of pwMS (Fernández‐Pablos et al, 2016; Saposnik et al, 2021). Importantly, they can capture the perception of their symptoms more closely.…”

Section: Introductionmentioning

confidence: 99%

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The role of specialist nurses in detecting spasticity and related symptoms in multiple sclerosis

Artola

Hernando

Vidal

et al. 2022

Journal of Clinical Nursing

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Background Spasticity is a frequent symptom of multiple sclerosis (MS), which may negatively influence daily living activities (ADL). Objectives To (1) explore the feasibility to conduct a structured interview by specialist nurses about limitations in ADL; (2) determine the percentage of people with MS (PwMS) with limitations in ADL related to spasticity; (3) to assess the knowledge about spasticity and describe its clinical features. Design Observational, cross‐sectional, multicentre study in 16 MS units of Catalonia (Spain). Participants were recruited from the outpatient facility and day‐care hospital between July 2018 and June 2019 and met the following criteria: (1) age 18 or older, (2) diagnosis of MS according to McDonald criteria 2010 and (3) no clinical relapse in previous 30 days. Methods Specialist nurses conducted a structured interview divided in two parts: the assessment of (1) limitations in the ADL and (2) the presence of spasticity and associated symptoms. The usefulness of this intervention was requested. This study met the STROBE reporting guidelines checklist for observational studies. Results Three hundred sixty eight pwMS (244 women) with a mean age of 46 years and a median Expanded Disability Status Scale score of 2.5 (range, 0–8.5) were included. 262 (71%) pwMS had limitations in the ADL, and spasticity was reported as the most limiting symptom in 59 (23%). As a result of the interview, spasticity was observed in 199 (76%) participants; 47 (24%) of them were unaware that they had spasticity and 102 (51%) would not have reported it spontaneously. The level of the interview satisfaction was high (90%). Conclusions Spasticity is a complex and limiting symptom in MS. The structured interview conducted by specialist nurses is feasible and has good acceptance. Patient contribution Specialist nurses can be proactive in MS clinical assessment, which may help to detect symptoms with negative impact on quality of life.

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“…De esta forma, visibilizar los síntomas tabúes podría contribuir a que los pacientes fueran más activos en su control y gestión. Por su parte, el personal de enfermería podrá detectar y ayudar al paciente a detectar las necesidades asistenciales de cada momento [129] .…”

Section: Situación Idealunclassified

SROI-EM. Impacto clínico, asistencial, económico y social del abordaje ideal de la Esclerosis Múltiple en comparación con el abordaje actual

Merino¹,

Jiménez²,

Gómez-García³

et al. 2018

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Retorno social de la inversión _____________________________________ 7.2.1 Inicios del SROI ________________________________________________________ 7.2.2 Metodología básica del SROI _____________________________________________ 7.3 Otros aspectos metodológicos _________________________________________ 8 Abordaje ideal de la Esclerosis Múltiple _________________________________ 9 Retorno Social de la Inversión del abordaje ideal __________________________ 9.1 Grupos de interés ___________________________________________________ 9.2 Marco general de la inversión y el retorno _______________________________ 9.3 Propuestas del área de Diagnóstico _____________________________________ 9.3.1 Propuesta 1. Formación en EM y sus síntomas tanto a neurología no especialista en EM como a profesionales sanitarios de otras áreas vinculadas a los pacientes con EM. _______ 9.3.2 Propuesta 2. Coordinación entre medicina de atención primaria y neurología, a través de vías de contacto directo. ____________________________________________________ 9.3.3 Propuesta 3. Disminución de las listas de espera en la especialidad de neurología. __ 9.3.4 Propuesta 4. Acceso rápido a la prueba de resonancia magnética por imagen. _____ 9.3.5 Propuesta 5. Visita de resultados de pruebas diagnósticas en máximo 30 días. _____ [Impacto clínico, asistencial, económico y social del abordaje ideal de la Esclerosis Múltiple en comparación con el abordaje actual-Proyecto SROI-EM] INFORME FINAL [6] 9.3.6 Propuesta 6. Visita precoz con neurología tras el diagnóstico. ___________________ 9.3.7 Resumen de la inversión y del retorno en el área de Diagnóstico. ________________ 9.4 Propuestas del área de EM remitente-recidivante _________________________ 9.4.1 Propuesta 7. Coordinación entre medicina de atención primaria y neurología, a través de vías de contacto directo. ____________________________________________________ 9.4.2 Propuesta 8. Protocolo sobre el seguimiento de los pacientes acorde a los criterios de gravedad de la enfermedad. ___________________________________________________ 9.4.3 Propuesta 9. Realización de resonancia magnética una vez al año como mínimo. ___ 9.4.4 Propuesta 10. Acceso universal a las consultas monográficas y/o unidades multidisciplinares de EM en todo el Sistema Nacional de Salud. _______________________ 9.4.5 Propuesta 11. Acceso a tratamiento modificador de la enfermedad para los pacientes con EMRR no tratados en la actualidad. __________________________________________ 9.4.6 Propuesta 12. Educación sobre hábitos saludables a pacientes a través de enfermería hospitalaria especialista en EM. _________________________________________________ 9.4.7 Resumen de la inversión y del retorno en el área de EMRR. ____________________ 9.5 Propuestas del área de EM formas progresivas ____________________________ 9.5.1 Propuesta 13. Coordinación entre medicina de atención primaria y otros especialistas implicados en el seguimiento de la enfermedad, a través de vías de contacto directo. _____ 9.5.2 Propuesta 14. Atención y tratamiento de...

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Manejo de los síntomas asociados a la espasticidad en pacientes con esclerosis múltiple

Cited by 3 publications

References 9 publications

Spasticity-Plus syndrome in multiple sclerosis patients in a tertiary hospital in Spain

Spasticity-Plus syndrome in multiple sclerosis patients in a tertiary hospital in Spain

The role of specialist nurses in detecting spasticity and related symptoms in multiple sclerosis

SROI-EM. Impacto clínico, asistencial, económico y social del abordaje ideal de la Esclerosis Múltiple en comparación con el abordaje actual

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