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.
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Acknowledgments
Performance Scales, Copyright Registration Number/Date: TXu000743629 / 1996-04-04; assigned to DeltaQuest Foundation, Inc., effective October 1, 2005. US Copyright law governs terms of use.
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All authors were involved in the design of the study, data analysis and interpretation, and writing of the manuscript.
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Funding
The NARCOMS Registry is funded, in part, by the Consortium of MS Centers and its Foundation.
Conflict of interest
Dr Bethoux received honoraria for consulting from IMPAX Laboratories, FLEX Pharma, and Concert Pharmaceuticals, honoraria for scientific advisory board meetings from Merz Pharma, and research funding (paid to his institution) from Merz Pharma. Dr Marrie receives research funding for studies on multiple sclerosis from Canadian Institutes of Health Research, Research Manitoba, Multiple Sclerosis Society of Canada, Multiple Sclerosis Scientific Foundation, National Multiple Sclerosis Society, Rx & D Health Research Foundation, and has conducted clinical trials funded by Sanofi-Aventis (no personal compensation).
Ethical approval
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The NARCOMS registry is approved by the Institutional Review Board of the University of Alabama at Birmingham.
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All participants enrolled in the NARCOMS registry have provided written or electronic informed consent for the use of their de-identified data for research purposes.
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Bethoux, F., Marrie, R.A. A Cross-Sectional Study of the Impact of Spasticity on Daily Activities in Multiple Sclerosis. Patient 9, 537–546 (2016). https://doi.org/10.1007/s40271-016-0173-0
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DOI: https://doi.org/10.1007/s40271-016-0173-0