Highlights
- •Spasticity affects up to 85% of patients with multiple sclerosis.
- •After adjusting for confounders spasticity was found to be an independent determinant of worse quality of life in multiple sclerosis.
- •There is a strong association between spasticity and fatigue, depression, anxiety, pain and bladder problems.
- •Effective pharmacological and non-pharmacological treatments of spasticity are needed to improve the quality of life of patients with multiple sclerosis.
Abstract
Objectives
- (1)To determine the association between spasticity and quality of life (QOL) in multiple sclerosis (MS).
- (2)To investigate the associations between spasticity and impairments of function and activity limitations.
Design
Cross-sectional survey.
Setting
A convenience sample of people with MS routinely attending an appointment with their
local MS service.
Participants
701 patients with clinically definite MS.
Main outcome measures
Demographic details were obtained and patients completed a battery of measures including
spasticity (Multiple Sclerosis Spasticity Scale – 88), fatigue (Neurological Fatigue
Index – MS), urinary dysfunction (Qualiveen-SF), pain (Neuropathic Pain Scale), mood
disorder (Hospital Anxiety and Depression Scale), disability (World Health Organisation
Disability Assessment Schedule) and QOL (Leeds Multiple Sclerosis QOL Scale).
Results
85.7% of patients reported spasticity. Patients with higher levels of spasticity were
more likely to be disabled, suffer from depression and anxiety, have higher levels
of fatigue and report more pain and bladder problems (p<0.01). Spasticity remained as a significant direct effect upon QOL in a multivariate
model adjusted for other impairments, activity limitation and depression.
Conclusions
There is a strong association between spasticity and fatigue, depression, anxiety,
pain and bladder problems. The retention of a significant direct relationship with
QOL in a multivariate model emphasises its influence upon the everyday lives of people
with MS.
Keywords
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Article info
Publication history
Published online: October 21, 2015
Accepted:
October 20,
2015
Received in revised form:
October 6,
2015
Received:
August 9,
2015
Identification
Copyright
© 2015 Elsevier B.V. Published by Elsevier Inc. All rights reserved.
