The prevalence and effect of problematic spasticity following traumatic spinal cord injury

Publication date: Available online 22 October 2016
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Kaila A. Holtz, Rachel Lipson, Vanessa K. Noonan, Brian K. Kwon, Patricia B. Mills
ObjectiveTo evaluate the prevalence and impact of spasticity following traumatic spinal cord injury (SCI).DesignProspective cohort study of the Rick Hansen Spinal Cord Injury Registry (RHSCIR) and retrospective review of inpatient medical charts.SettingQuaternary trauma centre, rehabilitation centre, and community settings in British Columbia, Canada.ParticipantsIndividuals with a traumatic SCI between 2005 and 2014 prospectively enrolled in the Vancouver site RHSCIR were eligible for inclusion.InterventionsNot applicable.Main Outcome MeasuresOutcome measures included questionnaires (Penn Spasm Frequency Scale; Spinal Cord Injury Health Questionnaire) and anti-spasticity medication use.ResultsIn 465 patients, the prevalence of spasticity at community discharge was 65%, and the prevalence of problematic spasticity (defined as discharged on anti-spasticity medication) was 35%. Problematic spasticity was associated with cervicothoracic neurologic level and injury severity (p<0.001). In community follow-up, the prevalence of patients reporting any spasticity treatment (i.e. problematic spasticity) was 35% at 1, 40% at 2, and 29% at 5 years post-injury. Interference with function due to spasticity was reported by 27% of patients at 1, 24% at 2 and 20% at 5 years post-injury. Patients with American Spinal Injury Association Impairment Scale (AIS) grade C injuries had the highest prevalence of ongoing spasticity treatment and functional limitation.ConclusionsSpasticity is a highly prevalent secondary consequence of SCI, particularly in patients with severe motor incomplete cervicothoracic injuries. It is problematic in one third of all SCI patients up to 5 years post-injury. One in five patients will suffer from ongoing functional limitation related to spasticity, highlighting the importance of close community follow-up and need for further research into spasticity management strategies.



from Rehabilitation via xlomafota13 on Inoreader http://ift.tt/2eHCvYn
via IFTTT