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Our resident PT expert suggests stretching every day, ideally three times a day, to help control spasticity. Based upon the below study, just released, its importance cannot be understated. - D
Onset of multiple sclerosis-related spasticity and its impact on health-related quality of life as measured by EQ-5D and HAQUAMS
D. Wynn, R. Schapiro, A. AL-Sabbagh, D. Lissin, E. Jones, J. Pike (Northbrook, Eagle, Santa Clara, US; Macclesfield, UK)
Background: Multiple sclerosis (MS) is a chronic, progressive disease, often accompanied by functional impairment due to spasticity. It is hypothesized that as the severity of spasticity increases there is a corresponding impact on health-related quality of life (HRQoL).
Objective: To quantify the relationship between physician-reported severity of spasticity and HRQoL as measured by Euroqol-5D (EQ-5D) and Hamburg Quality of Life Assessment in Multiple Sclerosis (HAQUAMS).
Methods: Data were drawn from the Adelphi MS Disease Specific Programme, a cross-sectional study of 125 neurologists in the USA. Participating neurologists completed a patient record form for the next 12-15 consulting MS patients and the same patients were invited to fill out a patient self-completion form (PSC). Of the 904 who completed a PSC, 439 provided information on all the elements required for this analysis. Preliminary analysis using ANOVA with Bonferroni-corrected t-tests established that the most appropriate split was between the physician-assessed mild and moderate spasticity levels. Double robust estimates (combining propensity scoring with a weighted regression) were subsequently calculated to show the differences in HRQoL between patients with moderate or severe spasticity and those with no or mild spasticity. Confounding factors included Expanded Disability Severity Scale (EDSS), gender, age, body mass index, presence and number of concomitant conditions, compliance and MS type.
Results: Compared with patients with no or mild spasticity, for both EQ-5D and HAQUAMS, presence of moderate or severe spasticity was associated with a poorer HRQoL indicated by a reduction of 0.12 in EQ-5D (p<0.01), an increase of 0.36 in overall HAQUAMS (p<0.01) and an increase in HAQUAMS subscales as follows: fatigue/thinking +0.36 (p<0.05), lower limb mobility +0.73 (p<0.001) and upper limb mobility +0.53 (p<0.001).
Conclusion: Moderate or severe spasticity is associated with a significantly worse HRQoL as measured by EQ-5D and HAQUAMS versus patients with no or mild spasticity. Patients with moderate or severe spasticity could therefore benefit from a therapy that specifically addresses the severity of spasticity.
Onset of multiple sclerosis-related spasticity and its impact on health-related quality of life as measured by EQ-5D and HAQUAMS
D. Wynn, R. Schapiro, A. AL-Sabbagh, D. Lissin, E. Jones, J. Pike (Northbrook, Eagle, Santa Clara, US; Macclesfield, UK)
Background: Multiple sclerosis (MS) is a chronic, progressive disease, often accompanied by functional impairment due to spasticity. It is hypothesized that as the severity of spasticity increases there is a corresponding impact on health-related quality of life (HRQoL).
Objective: To quantify the relationship between physician-reported severity of spasticity and HRQoL as measured by Euroqol-5D (EQ-5D) and Hamburg Quality of Life Assessment in Multiple Sclerosis (HAQUAMS).
Methods: Data were drawn from the Adelphi MS Disease Specific Programme, a cross-sectional study of 125 neurologists in the USA. Participating neurologists completed a patient record form for the next 12-15 consulting MS patients and the same patients were invited to fill out a patient self-completion form (PSC). Of the 904 who completed a PSC, 439 provided information on all the elements required for this analysis. Preliminary analysis using ANOVA with Bonferroni-corrected t-tests established that the most appropriate split was between the physician-assessed mild and moderate spasticity levels. Double robust estimates (combining propensity scoring with a weighted regression) were subsequently calculated to show the differences in HRQoL between patients with moderate or severe spasticity and those with no or mild spasticity. Confounding factors included Expanded Disability Severity Scale (EDSS), gender, age, body mass index, presence and number of concomitant conditions, compliance and MS type.
Results: Compared with patients with no or mild spasticity, for both EQ-5D and HAQUAMS, presence of moderate or severe spasticity was associated with a poorer HRQoL indicated by a reduction of 0.12 in EQ-5D (p<0.01), an increase of 0.36 in overall HAQUAMS (p<0.01) and an increase in HAQUAMS subscales as follows: fatigue/thinking +0.36 (p<0.05), lower limb mobility +0.73 (p<0.001) and upper limb mobility +0.53 (p<0.001).
Conclusion: Moderate or severe spasticity is associated with a significantly worse HRQoL as measured by EQ-5D and HAQUAMS versus patients with no or mild spasticity. Patients with moderate or severe spasticity could therefore benefit from a therapy that specifically addresses the severity of spasticity.
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