OBJECTIVES To determine the prevalence, rate of underdiagnosis and undertreatment, and association with activities of daily living dependency of spasticity in a nursing home setting. DESIGN Cross-sectional study. SETTING AND PARTICIPANTS This study is an analysis of a deidentified data set generated by a prior quality improvement project at a 240-bed nursing home for residents receiving long-term care or skilled nursing care services. METHODS Each resident was examined by a movement disorders specialist neurologist to determine whether spasticity was present and, if so, the total number of spastic postures present in upper and lower limbs was recorded. Medical records, including the Minimum Data Set, were reviewed for neurologic diagnoses associated with spasticity, activities of daily living (ADL) dependency, and prior documentation of diagnosis and past or current treatments. Ordinary least squares linear regression models were used to evaluate the association between spasticity and ADL dependency. RESULTS Two hundred nine residents (154 women, 81.9 ± 10.9 years) were included in this analysis. Spasticity was present in 22% (45/209) of residents examined by the neurologist. Only 11% of residents (5/45) had a prior diagnosis of spasticity and were receiving treatment. Presence of spasticity was associated with greater ADL dependency (χ2 = 51.72, P < .001), which was driven by lower limb spasticity (χ2 = 14.56, P = .006). CONCLUSIONS AND IMPLICATIONS These results suggest that spasticity (1) is common in nursing homes (1 of 5 residents), (2) is often not diagnosed or adequately treated, and (3) is associated with worse ADL dependency. Further research is needed to enhance the rates of diagnosis and treatment of spasticity in long-term care facilities.

中文翻译：

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疗养院居民痉挛的患病率

目的 确定疗养院环境中痉挛的患病率、诊断不足和治疗不足的发生率以及与日常生活依赖活动的关联。设计横断面研究。设置和参与者 本研究分析了由先前质量改进项目在 240 个床位的疗养院为接受长期护理或专业护理服务的居民生成的未识别数据集。方法 运动障碍专科神经学家对每位住院医师进行检查以确定是否存在痉挛，如果存在，记录上肢和下肢痉挛姿势的总数。对包括最小数据集在内的医疗记录进行了审查，以确定与痉挛、日常生活活动 (ADL) 依赖、以及先前的诊断和过去或当前治疗的文件。普通最小二乘线性回归模型用于评估痉挛和 ADL 依赖性之间的关联。结果 该分析包括 209 名居民（154 名女性，81.9 ± 10.9 岁）。神经科医师检查的居民中有 22% (45/209) 出现痉挛。只有 11% 的居民 (5/45) 事先被诊断为痉挛状态并正在接受治疗。痉挛的存在与更大的 ADL 依赖性相关（χ2 = 51.72，P < .001），这是由下肢痉挛引起的（χ2 = 14.56，P = .006）。结论和意义 这些结果表明，痉挛 (1) 在疗养院中很常见（5 名居民中的 1 名），(2) 通常未被诊断或得到充分治疗，以及 (3) 与更严重的 ADL 依赖相关。