Spasticity in multiple sclerosis: Associations with impairments and overall quality of life

Abstract

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: Depression; Disability; Fatigue; Multiple sclerosis; Quality of life; Spasticity.