Spasticity in Multiple Sclerosis

Abstract

The objective of this article is to establish the prevalence of spasticity in a random selection of people with multiple sclerosis (MS) in the city of Newcastle upon Tyne in the Northeast of England. A secondary aim was to assess the adequacy of current pharmacological intervention for spasticity and assess the relationship between spasticity and overall disability. The study design was a simple comparison that examined differences in functional independence in 2 random groups of people with MS subdivided by the presence of clinically significant spasticity. A total of 68 adults with a diagnosis of clinically definite MS were included in the study. Their level of functional independence was assessed using the Newcastle Independence Assessment Form (NIAF), the Functional Independence Measure (FIM), and the Kurtzke Extended Disability Status Scale (EDSS). Spasticity was assessed using the Modified Ashworth Scale. A subjective analysis was made of the appropriateness of oral antispastic medication by a rehabilitation physician. Thirty-two people (47%) had clinically significant spasticity (Modified Ashworth Score of 2, 3, or 4). Seventy-eight percent of the population were receiving some oral antispastic medication, but 50% were deemed to require some drug adjustment or additional treatment. Individuals with spasticity were found to have significantly higher levels of disability than those who had no spasticity or clinically insignificant spasticity. This study has confirmed that spasticity is highly prevalent in the MS population and is significantly associated with a reduced level of functional independence. Treatment of spasticity is suboptimal in a large proportion of the population, and the need for further information and education to health professionals and to people with MS is highlighted.

Transcranial magnetic stimulation primes the effects of exercise therapy in multiple sclerosis

“…Spasticity is highly prevalent in the MS population and is significantly associated with a reduced level of functional independence [12]. We therefore aimed at investigating whether the combination of rTMS and ET may result in further significant reduction of disability and ameliorated quality of life in MS patients.…”

Spastic movement disorder: impaired reflex function and altered muscle mechanics

“…Anti-spastic drug therapy is thought to be predominantly of benefit for immobilised patients by reducing muscle tone and relieving muscle spasms 137 , which may in turn improve nursing care for these patients.…”

Evidence for the efficacy and effectiveness of THC-CBD oromucosal spray in symptom management of patients with spasticity due to multiple sclerosis

“…Spasticity is one of the more common symptoms of MS, as it affects more than 80% of MS patients during the course of the disease [Barnes et al 2003;Beard et al 2003;Rizzo et al 2004]. Spasticity can be defined from the pathophysiological perspective as a 'disordered sensorimotor control resulting from an upper motor neuron lesion, presenting as intermittent or sustained involuntary activation of muscles' [Stevenson, 2010].…”