Article

OBJECTIVE: To evaluate the prevalence and effect of spasticity after traumatic
spinal cord injury (SCI). DESIGN: Prospective cohort study of the Rick Hansen
Spinal Cord Injury Registry (RHSCIR) and retrospective review of inpatient
medical charts. SETTING: Quaternary trauma center, rehabilitation center, and
community settings. PARTICIPANTS: Individuals (N=860) with a traumatic SCI
between March 1, 2005, and March 31, 2014, prospectively enrolled in the
Vancouver site RHSCIR were eligible for inclusion. INTERVENTIONS: Not applicable.
MAIN OUTCOME MEASURES: Questionnaires (Penn Spasm Frequency Scale, Spinal Cord
Injury Health Questionnaire) and antispasticity medication use. RESULTS: In 465
patients, the prevalence of spasticity at community discharge was 65%, and the
prevalence of problematic spasticity (defined as discharged on antispasticity
medication) was 35%. Problematic spasticity was associated with cervicothoracic
neurologic level and injury severity (P<.001). In community follow-up, the
prevalence of patients reporting any spasticity treatment (ie, problematic
spasticity) was 35% at 1 year, 41% at 2 years, and 31% at 5 years postinjury.
Interference with function caused by spasticity was reported by 27% of patients
at 1 year, 25% at 2 years, and 20% at 5 years postinjury. Patients with American
Spinal Injury Association Impairment Scale grade C injuries had the highest
prevalence of ongoing spasticity treatment and functional limitation.
CONCLUSIONS: Spasticity is a highly prevalent secondary consequence of SCI,
particularly in patients with severe motor incomplete cervicothoracic injuries.
It is problematic in one third of all patients with SCI up to 5 years postinjury.
One in 5 patients will have ongoing functional limitations related to spasticity,
highlighting the importance of close community follow-up and the need for further
research into spasticity management strategies.
CI - Copyright (c) 2016 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS