Clinical Outcome Assessments for Spasticity: Review, Critique, and Recommendations

IF 7.4 1区医学 Q1 CLINICAL NEUROLOGY

Movement Disorders Pub Date : 2024-12-04 DOI:10.1002/mds.30062

Ota Gal PhD, Marjolaine Baude MD, Thierry Deltombe MD, Alberto Esquenazi MD, FAAPMR, Jean-Michel Gracies MD, PhD, Martina Hoskovcova MD, PhD, Carmen Rodriguez-Blazquez PhD, Raymond Rosales MD, PhD, Lalith Satkunam MBBS, FRCPC, Jörg Wissel MD, FRCP, Tiago Mestre MD, PhD, Álvaro Sánchez-Ferro MD, PhD, Matej Skorvanek MD, PhD, Michelle Hyczy de Siqueira Tosin MHS, PhD, Robert Jech MD, PhD, the members of the MDS Clinical Outcome Assessments Scientific Evaluation Committee and MDS Spasticity Study group

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引用次数: 0

Abstract

Background

Spasticity is a common feature in patients with disruptions in corticospinal pathways. However, the term is used ambiguously. Here, spasticity is defined as enhanced velocity-dependent stretch reflexes and placed within the context of deforming spastic paresis encompassing other forms of muscle overactivity.

Objective

This scoping review aims at evaluating the clinimetric quality of clinical outcome assessments (COAs) for spasticity across different pathologies and to make recommendations for their use.

Methods

A literature search was conducted to identify COAs used to assess spasticity. An international expert panel evaluated the measurement properties in the included COAs. Recommendations were based on the MDS-COA program methodology based on three criteria: if the COA was (1) applied to patients with spastic paresis, (2) used by others beyond the developers, and (3) determined to be reliable, valid, and sensitive to change in patients with spasticity.

Results

We identified 72 COAs of which 17 clinician-reported outcomes (ClinROs) and 6 patient-reported outcomes (PROs) were reviewed. The Tardieu Scale was the only ClinRO recommended for assessing spasticity. One ClinRO—Composite Spasticity Index—and two PROs—Spasticity 0–10 Numeric Rating Scale and 88-Item Multiple Sclerosis Spasticity Scale—were recommended with caveats. The Ashworth-derived COAs were excluded after evaluation due to their focus on muscle tone rather than spasticity, as defined in this review.

Conclusions

The Tardieu Scale is recommended for assessing spasticity, and two PROs are recommended with caveats. Consistent terminology about the various types of muscle overactivity is necessary to facilitate their assessment and treatment. © 2024 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

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查看原文本刊更多论文

痉挛的临床结果评估：回顾、批评和建议。

背景：痉挛是皮质脊髓通路中断患者的共同特征。然而，这个术语的用法含糊不清。在这里，痉挛被定义为速度依赖性的拉伸反射增强，并被置于包括其他形式的肌肉过度活动的变形性痉挛性轻瘫的背景下。目的：本综述旨在评估不同病理痉挛的临床结果评估（COAs）的临床质量，并对其使用提出建议。方法：通过文献检索确定用于评估痉挛的coa。一个国际专家小组评估了所含coa的测量特性。建议是基于MDS-COA程序方法，基于三个标准：如果COA(1)适用于痉挛性轻瘫患者，(2)被开发人员以外的其他人使用，(3)确定为可靠，有效，对痉挛患者的变化敏感。结果：我们确定了72个coa，其中17个临床报告的结果（ClinROs）和6个患者报告的结果（PROs）被审查。Tardieu量表是唯一推荐用于评估痉挛的ClinRO。建议使用一个clinro -复合痉挛指数和两个pro -痉挛0-10数值评定量表和88项多发性硬化症痉挛量表。ashworth衍生的coa在评估后被排除，因为它们关注的是肌肉张力而不是痉挛，如本文所定义的那样。结论：推荐使用Tardieu量表评估痉挛，并推荐使用两种pro，但需注意。关于各种类型肌肉过度活动的一致术语是必要的，以方便他们的评估和治疗。©2024作者。Wiley期刊有限责任公司代表国际帕金森和运动障碍学会出版的《运动障碍》。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Movement Disorders 医学-临床神经学

CiteScore

13.30

自引率

8.10%

发文量

371

审稿时长

12 months

期刊介绍： Movement Disorders publishes a variety of content types including Reviews, Viewpoints, Full Length Articles, Historical Reports, Brief Reports, and Letters. The journal considers original manuscripts on topics related to the diagnosis, therapeutics, pharmacology, biochemistry, physiology, etiology, genetics, and epidemiology of movement disorders. Appropriate topics include Parkinsonism, Chorea, Tremors, Dystonia, Myoclonus, Tics, Tardive Dyskinesia, Spasticity, and Ataxia.