Objective

To characterize the qualities that individuals with spinal cord injury (SCI) associate with their experience of spasticity and to describe the relationship between spasticity and perceived quality of life and the perceived value of spasticity management approaches.

Design

Online cross-sectional survey.

Setting

Multicenter collaboration among 6 Spinal Cord Injury Model Systems hospitals in the United States.

Participants

Individuals with SCI (N=1076).

Interventions

Not applicable.

Main Outcome Measures

Qualities of Spasticity Questionnaire, modified Spinal Cord Injury–Spasticity Evaluation Tool (mSCI-SET), and the modified Patient-Reported Impact of Spasticity Measure (mPRISM).

Results

Respondents indicated that spasms most often occurred in response to movement-related triggering events. However, spontaneous spasms (ie, no triggering event) were also reported to be among the most common types. Frequency of spasms appears to decline with age. The highest frequency of spasms was reported by 56% of respondents aged <25 years and by only 28% of those >55 years. Stiffness associated with spasticity was reported to be more common than spasms (legs, 65% vs 54%; trunk, 33% vs 18%; arms, 26% vs 15%). Respondents reported negative effects of spasticity more commonly than positive effects. Based on their association with negative scores on the mSCI-SET and the mPRISM, the 5 most problematic experiences reported were stiffness all day, interference with sleep, painful spasms, perceived link between spasticity and pain, and intensification of pain before a spasm. Respondents indicated spasticity was improved more by stretching (48%) and exercise (45%) than by antispasmodics (38%).

Conclusions

The experience of spasticity after SCI is complex and multidimensional, with consequences that affect mobility, sleep, comfort, and quality of life. Stiffness, rather than spasms, appears to be the most problematic characteristic of spasticity. Physical therapeutic interventions to treat spasticity warrant in-depth investigation.

中文翻译：

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表征脊髓损伤后痉挛的经历：脊髓损伤模型系统中心的全国调查项目

客观的

描述脊髓损伤 (SCI) 患者与其痉挛经历相关的品质，并描述痉挛与感知生活质量之间的关系以及痉挛管理方法的感知价值。

设计

在线横断面调查。

环境

美国 6 家脊髓损伤模型系统医院之间的多中心合作。

参与者

SCI 患者 (N=1076)。

干预措施

不适用。

主要观察指标

痉挛质量问卷、改良的脊髓损伤-痉挛评估工具 (mSCI-SET) 和改良的患者报告的痉挛测量影响 (mPRISM)。

结果

受访者表示，痉挛最常发生在与运动相关的触发事件中。然而，据报道，自发性痉挛（即无触发事件）也是最常见的类型。痉挛的频率似乎随着年龄的增长而下降。56% 的年龄 <25 岁的受访者报告痉挛的最高频率，只有 28% 的年龄 >55 岁。据报道，与痉挛相关的僵硬比痉挛更常见（腿部，65% 对 54%；躯干，33% 对 18%；手臂，26% 对 15%）。受访者报告的痉挛的负面影响比正面影响更常见。根据它们与 mSCI-SET 和 mPRISM 负分的关联，报告的 5 个最有问题的体验是全天僵硬、干扰睡眠、疼痛性痉挛、痉挛和疼痛之间的感知联系、和痉挛前的疼痛加剧。受访者表示，拉伸（48%）和运动（45%）比抗痉挛药（38%）更能改善痉挛状态。

结论

SCI 后的痉挛经历是复杂且多维度的，其后果会影响活动能力、睡眠、舒适度和生活质量。僵硬，而不是痉挛，似乎是痉挛最有问题的特征。治疗痉挛的物理治疗干预值得深入研究。