Skip to main content
Top
Published in: The Patient - Patient-Centered Outcomes Research 6/2016

01-12-2016 | Original Research Article

A Cross-Sectional Study of the Impact of Spasticity on Daily Activities in Multiple Sclerosis

Authors: Francois Bethoux, Ruth Ann Marrie

Published in: The Patient - Patient-Centered Outcomes Research | Issue 6/2016

Login to get access

Abstract

Background

Spasticity is frequently reported by patients with multiple sclerosis (MS). A previously published survey of participants in the North American Research Committee on Multiple Sclerosis (NARCOMS) registry showed that higher levels of spasticity were associated with higher MS-related disability and lower quality of life, but did not investigate the impact of spasticity on daily activities, and only partially assessed spasticity management.

Methods

A new cross-sectional survey was distributed to 15,679 eligible NARCOMS participants. We inquired about the degree of bother from symptoms associated with spasticity, interference with a variety of daily activities, as well as past and current treatments for spasticity.

Results

Among the 10,353 responders (66 % response rate), over 80 % reported experiencing spasticity, and more than 35 % were moderately or greatly bothered by stiffness, spasms, or pain, predominantly in the lower extremities. More severe spasticity was associated with worse disability, mobility, bladder function, and fatigue. Spasticity was most frequently reported to interfere with stair climbing, walking, and sleep. Most individuals reported receiving treatment for spasticity (mainly oral medications, stretching, home exercise, and physical therapy), yet fewer than half reported being satisfied with their current treatment.

Conclusion

Spasticity was reported by a large majority of patients with MS, and found to interfere with many daily activities. At the same time, patients were often dissatisfied with the effects of treatments for spasticity. Prospective studies are needed to better characterize the impact of spasticity in individuals with MS, and to optimize treatment strategies.
Appendix
Available only for authorised users
Literature
1.
go back to reference Bethoux F, Sutliff M. Management of spasticity. In: Cohen JA, Rudick RA, editors. Multiple Sclerosis Therapeutics. Fourth Edition. New York: Cambridge University Press; 2011. p. 668–677. Bethoux F, Sutliff M. Management of spasticity. In: Cohen JA, Rudick RA, editors. Multiple Sclerosis Therapeutics. Fourth Edition. New York: Cambridge University Press; 2011. p. 668–677.
2.
go back to reference Barnes MP, Kent RM, Semlyen JK, et al. Spasticity in multiple sclerosis. Neurorehabil Neural Repair. 2003;17:66–70.CrossRefPubMed Barnes MP, Kent RM, Semlyen JK, et al. Spasticity in multiple sclerosis. Neurorehabil Neural Repair. 2003;17:66–70.CrossRefPubMed
3.
go back to reference Haselkorn JK, Balsdon Richer C, Fry Welch D, et al. Multiple Sclerosis Council for Clinical Practice Guidelines. Overview of spasticity management in multiple sclerosis. Evidence-based management strategies for spasticity treatment in multiple sclerosis. J Spinal Cord Med. 2005;28(2):167–99.CrossRefPubMed Haselkorn JK, Balsdon Richer C, Fry Welch D, et al. Multiple Sclerosis Council for Clinical Practice Guidelines. Overview of spasticity management in multiple sclerosis. Evidence-based management strategies for spasticity treatment in multiple sclerosis. J Spinal Cord Med. 2005;28(2):167–99.CrossRefPubMed
4.
go back to reference Gold R, Oreja-Guevara C. Advances in the management of multiple sclerosis spasticity: multiple sclerosis spasticity guidelines. Expert Rev Neurother. 2013;13(12 Suppl):55–9.CrossRefPubMed Gold R, Oreja-Guevara C. Advances in the management of multiple sclerosis spasticity: multiple sclerosis spasticity guidelines. Expert Rev Neurother. 2013;13(12 Suppl):55–9.CrossRefPubMed
5.
go back to reference Rizzo MA, Hadjimichael OC, Preiningerova J, et al. Prevalence and treatment of spasticity reported by multiple sclerosis patients. Mult Scler. 2004;10:589–95.CrossRefPubMed Rizzo MA, Hadjimichael OC, Preiningerova J, et al. Prevalence and treatment of spasticity reported by multiple sclerosis patients. Mult Scler. 2004;10:589–95.CrossRefPubMed
7.
go back to reference Hohol MJ, Orav EJ, Weiner HL. Disease Steps in multiple sclerosis: a longitudinal study comparing disease steps and EDSS to evaluate disease progression. Mult Scler. 1999;5:349–54.CrossRefPubMed Hohol MJ, Orav EJ, Weiner HL. Disease Steps in multiple sclerosis: a longitudinal study comparing disease steps and EDSS to evaluate disease progression. Mult Scler. 1999;5:349–54.CrossRefPubMed
8.
go back to reference Learmonth YC, Motl RW, Sandroff BM, et al. Validation of patient determined disease steps (PDDS) scale scores in persons with multiple sclerosis. BMC Neurol. 2013;13:37.CrossRefPubMedPubMedCentral Learmonth YC, Motl RW, Sandroff BM, et al. Validation of patient determined disease steps (PDDS) scale scores in persons with multiple sclerosis. BMC Neurol. 2013;13:37.CrossRefPubMedPubMedCentral
9.
go back to reference Schwartz CE, Vollmer T, Lee H. Reliability and validity of two self-report measures of impairment and disability for MS. North American Research Consortium on Multiple Sclerosis Outcomes Study Group. Neurology. 1999;52(1):63–70.CrossRefPubMed Schwartz CE, Vollmer T, Lee H. Reliability and validity of two self-report measures of impairment and disability for MS. North American Research Consortium on Multiple Sclerosis Outcomes Study Group. Neurology. 1999;52(1):63–70.CrossRefPubMed
10.
go back to reference Marrie RA, Goldman MD. Validity of Performance Scales for disability assessment in multiple sclerosis. Mult Scler. 2007;13:1176–82.CrossRefPubMed Marrie RA, Goldman MD. Validity of Performance Scales for disability assessment in multiple sclerosis. Mult Scler. 2007;13:1176–82.CrossRefPubMed
11.
go back to reference World Health Organization. International Classification of Functioning, Disability and Health. Geneva; 2001. World Health Organization. International Classification of Functioning, Disability and Health. Geneva; 2001.
12.
go back to reference Kleinbaum D, Klein M. Logistic regression. A self-learning text. 2nd ed. New York: Springer-Verlag Inc.; 2002. Kleinbaum D, Klein M. Logistic regression. A self-learning text. 2nd ed. New York: Springer-Verlag Inc.; 2002.
13.
go back to reference Collins JG. Prevalence of selected chronic conditions, United States, 1986–88. National Center for Health Statistics. Vital Health Stat. 1993;10:1–87. Collins JG. Prevalence of selected chronic conditions, United States, 1986–88. National Center for Health Statistics. Vital Health Stat. 1993;10:1–87.
14.
go back to reference Jacobs LD, Wende KE, Brownscheidle CM, et al. A profile of multiple sclerosis: the New York State multiple sclerosis consortium. Mult Scler. 1999;5:369–76.CrossRefPubMed Jacobs LD, Wende KE, Brownscheidle CM, et al. A profile of multiple sclerosis: the New York State multiple sclerosis consortium. Mult Scler. 1999;5:369–76.CrossRefPubMed
15.
go back to reference Hughes C, Howard IM. Spasticity management in multiple sclerosis. Phys Med Rehabil Clin N Am. 2013;24(4):593–604.CrossRefPubMed Hughes C, Howard IM. Spasticity management in multiple sclerosis. Phys Med Rehabil Clin N Am. 2013;24(4):593–604.CrossRefPubMed
16.
go back to reference Novotna A, Mares J, Ratcliffe S, et al. A randomized, double-blind, placebo-controlled, parallel-group, enriched-design study of nabiximols* (Sativex(®)), as add-on therapy, in subjects with refractory spasticity caused by multiple sclerosis. Eur J Neurol. 2011;18(9):1122–31.CrossRefPubMed Novotna A, Mares J, Ratcliffe S, et al. A randomized, double-blind, placebo-controlled, parallel-group, enriched-design study of nabiximols* (Sativex(®)), as add-on therapy, in subjects with refractory spasticity caused by multiple sclerosis. Eur J Neurol. 2011;18(9):1122–31.CrossRefPubMed
17.
go back to reference Bensmail D, Marquer A, Roche N, et al. Pilot study assessing the impact of intrathecal baclofen administration mode on sleep-related respiratory parameters. Arch Phys Med Rehabil. 2012;93(1):96–9.CrossRefPubMed Bensmail D, Marquer A, Roche N, et al. Pilot study assessing the impact of intrathecal baclofen administration mode on sleep-related respiratory parameters. Arch Phys Med Rehabil. 2012;93(1):96–9.CrossRefPubMed
18.
go back to reference Merlino G, Fratticci L, Lenchig C, et al. Prevalence of ‘poor sleep’ among patients with multiple sclerosis: an independent predictor of mental and physical status. Sleep Med. 2009;10(1):26–34.CrossRefPubMed Merlino G, Fratticci L, Lenchig C, et al. Prevalence of ‘poor sleep’ among patients with multiple sclerosis: an independent predictor of mental and physical status. Sleep Med. 2009;10(1):26–34.CrossRefPubMed
19.
go back to reference Sosnoff JJ, Gappmaier E, Frame A, et al. Influence of spasticity on mobility and balance in persons with multiple sclerosis. J Neurol Phys Ther. 2011;35(3):129–32.CrossRefPubMed Sosnoff JJ, Gappmaier E, Frame A, et al. Influence of spasticity on mobility and balance in persons with multiple sclerosis. J Neurol Phys Ther. 2011;35(3):129–32.CrossRefPubMed
20.
go back to reference Shakespeare DT, Boggild M, and Young C. Anti-spasticity agents for multiple sclerosis. Cochrane Database Syst Rev 2003;4:CD001332. Shakespeare DT, Boggild M, and Young C. Anti-spasticity agents for multiple sclerosis. Cochrane Database Syst Rev 2003;4:CD001332.
21.
go back to reference Simpson DM, Gracies JM, Graham HK, et al. Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Assessment: Botulinum neurotoxin for the treatment of spasticity (an evidence-based review): report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology. 2008;70(19):1691–8.CrossRefPubMed Simpson DM, Gracies JM, Graham HK, et al. Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Assessment: Botulinum neurotoxin for the treatment of spasticity (an evidence-based review): report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology. 2008;70(19):1691–8.CrossRefPubMed
22.
go back to reference Sadiq SA, Wang GC. Long-term intrathecal baclofen therapy in ambulatory patients with spasticity. J Neurol. 2006;253(5):563–9.CrossRefPubMed Sadiq SA, Wang GC. Long-term intrathecal baclofen therapy in ambulatory patients with spasticity. J Neurol. 2006;253(5):563–9.CrossRefPubMed
23.
go back to reference Zahavi A, Geertzen JH, Middel B, et al. Long term effect (more than five years) of intrathecal baclofen on impairment, disability, and quality of life in patients with severe spasticity of spinal origin. J Neurol Neurosurg Psychiatry. 2004;75(11):1553–7.CrossRefPubMedPubMedCentral Zahavi A, Geertzen JH, Middel B, et al. Long term effect (more than five years) of intrathecal baclofen on impairment, disability, and quality of life in patients with severe spasticity of spinal origin. J Neurol Neurosurg Psychiatry. 2004;75(11):1553–7.CrossRefPubMedPubMedCentral
24.
go back to reference Poulos C, Kinter E, Yang JC, Bridges JF, Posner J, Reder AT. Patient preferences for injectable treatments for multiple sclerosis in the United States: a discrete-choice experiment. Patient. 2016;9(2):171–80.CrossRefPubMed Poulos C, Kinter E, Yang JC, Bridges JF, Posner J, Reder AT. Patient preferences for injectable treatments for multiple sclerosis in the United States: a discrete-choice experiment. Patient. 2016;9(2):171–80.CrossRefPubMed
25.
go back to reference Collongues N, Vermersch P. Multiple sclerosis spasticity: ‘state-of-the-art’ questionnaire survey of specialized healthcare professionals. Expert Rev Neurother. 2013;13(3 Suppl 1):21–5.CrossRefPubMed Collongues N, Vermersch P. Multiple sclerosis spasticity: ‘state-of-the-art’ questionnaire survey of specialized healthcare professionals. Expert Rev Neurother. 2013;13(3 Suppl 1):21–5.CrossRefPubMed
26.
go back to reference Minden SL, Hoaglin DC, Hadden L, et al. Access to and utilization of neurologists by people with multiple sclerosis. Neurology. 2008;70:1141–9.CrossRefPubMed Minden SL, Hoaglin DC, Hadden L, et al. Access to and utilization of neurologists by people with multiple sclerosis. Neurology. 2008;70:1141–9.CrossRefPubMed
27.
go back to reference Bray M, Wolfson C, Moore F, et al. General practitioner preferences in managing care of multiple sclerosis patients. Can J Neurol Sci 2016;43(1):142–8.CrossRefPubMed Bray M, Wolfson C, Moore F, et al. General practitioner preferences in managing care of multiple sclerosis patients. Can J Neurol Sci 2016;43(1):142–8.CrossRefPubMed
Metadata
Title
A Cross-Sectional Study of the Impact of Spasticity on Daily Activities in Multiple Sclerosis
Authors
Francois Bethoux
Ruth Ann Marrie
Publication date
01-12-2016
Publisher
Springer International Publishing
Published in
The Patient - Patient-Centered Outcomes Research / Issue 6/2016
Print ISSN: 1178-1653
Electronic ISSN: 1178-1661
DOI
https://doi.org/10.1007/s40271-016-0173-0

Other articles of this Issue 6/2016

The Patient - Patient-Centered Outcomes Research 6/2016 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.