Article

Purpose - To assess prevalence, impact and treatment of spasticity in nursing home
patients with central nervous system (CNS) disorders.
Methods The Modified
Ashworth Scale was used as the main indicator of spasticity to assess muscle tone
of the extremities. Further information was obtained on burden of care, level of
independence, sleeping pattern, complaints, restrictions in
functions/activities/participation and indication for treatment. Clinical
assessments included coordination/sensibility parameters and various tests to
assess motor performance. Results Fifty-six out of 77 participants (73%) with CNS
disorders had spasticity, of whom 38 subjects also showed pathologically enhanced
reflexes and 45 subjects had contractures in various joints. A high burden of
care was observed in 71% and cramps/pain, cosmetic problems or other complaints
due to spasticity were seen in 46, 20 and 26%, respectively. The vast majority of
subjects were dependent for daily living activities and ambulation. Extra
treatment of spasticity was indicated for 36% of the patients. Conclusion A high
prevalence of spasticity was observed in nursing home residents with CNS
disorders associated with substantial impact in terms of caregiving, complaints
and compromised clinical outcome measures. To further optimize the treatment of
spasticity in this vulnerable population, regional treatment plans should be
developed. Implications for Rehabilitation The prevalence of spasticity in
nursing home residents with central nervous system disorders is high (73%). The
impact of spasticity is substantial in terms of increased dependency in
activities of daily living, increased burden of care, sleeping problems and many
complaints. Thirty-six percent of patients could be helped by extra specialized
treatment, so the challenge for the multidisciplinary rehabilitation team is
huge. Regional treatment plans should be developed to further optimize the
treatment of spasticity in the vulnerable ageing population of nursing home
residents.

Langue : ANGLAIS