Classification of upper limb spasticity patterns in patients with multiple sclerosis: a pilot observational study

Authors

  • Mirko Filippetti Neuromotor and Cognitive Rehabilitation Research Center, Section of Physical and Rehabilitation Medicine, Department of Neuroscience, Biomedicine, and Movement Sciences, University of Verona, Verona, Italy; Canadian Advances in Neuro-Orthopedics for Spasticity Consortium (CANOSC), Kingston, ON, Canada
  • Linde Lugoboni Neuromotor and Cognitive Rehabilitation Research Center, Section of Physical and Rehabilitation Medicine, Department of Neuroscience, Biomedicine, and Movement Sciences, University of Verona, Verona, Italy
  • Rita Di Censo Neuromotor and Cognitive Rehabilitation Research Center, Section of Physical and Rehabilitation Medicine, Department of Neuroscience, Biomedicine, and Movement Sciences, University of Verona, Verona, Italy; Neurorehabilitation Unit, Department of Neurosciences, University Hospital of Verona, Italy
  • Luca Degli Esposti Neuromotor and Cognitive Rehabilitation Research Center, Section of Physical and Rehabilitation Medicine, Department of Neuroscience, Biomedicine, and Movement Sciences, University of Verona, Verona, Italy
  • Salvatore Facciorusso Spasticity and Movement Disorders “ReSTaRt” Unit, Physical Medicine and Rehabilitation Section, Riuniti Hospital, University of Foggia, Foggia, Italy
  • Valentina Varalta Neuromotor and Cognitive Rehabilitation Research Center, Section of Physical and Rehabilitation Medicine, Department of Neuroscience, Biomedicine, and Movement Sciences, University of Verona, Verona, Italy; Neurorehabilitation Unit, Department of Neurosciences, University Hospital of Verona, Italy
  • Andrea Santamato Spasticity and Movement Disorders “ReSTaRt” Unit, Physical Medicine and Rehabilitation Section, Riuniti Hospital, University of Foggia, Foggia, Italy
  • Massimiliano Calabrese Neurology Section, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
  • Nicola Smania Neuromotor and Cognitive Rehabilitation Research Center, Section of Physical and Rehabilitation Medicine, Department of Neuroscience, Biomedicine, and Movement Sciences, University of Verona, Verona, Italy; Neurorehabilitation Unit, Department of Neurosciences, University Hospital of Verona, Italy
  • Alessandro Picelli Neuromotor and Cognitive Rehabilitation Research Center, Section of Physical and Rehabilitation Medicine, Department of Neuroscience, Biomedicine, and Movement Sciences, University of Verona, Verona, Italy; Canadian Advances in Neuro-Orthopedics for Spasticity Consortium (CANOSC), Kingston, ON, Canada; Neurorehabilitation Unit, Department of Neurosciences, University Hospital of Verona, Italy

DOI:

https://doi.org/10.2340/jrm.v56.40548

Keywords:

Botulinum toxins, Multiple sclerosis, Muscle spasticity, Symptom assessment, Upper extremity

Abstract

Objective: The aim of this study was to provide a classification of the upper limb patterns in patients with upper limb spasticity due to multiple sclerosis.

Design: Pilot observational study.

Patients: Twenty-five adult patients with multiple sclerosis suffering from upper limb spasticity who underwent one segmental (i.e., proximal and distal upper limb) botulinum toxin treatment cycle were recruited.

Methods: Patients remained in a sitting position during the evaluation. Upper limb spasticity postures (i.e., postural attitude of a single joint/anatomical region) were evaluated and recorded for the shoulder (adducted/internally rotated), elbow (flexed/extended), forearm (pronated/supinated/neutral), wrist (flexed/extended/neutral) and hand (fingers flexed/thumb in palm).

Results: On the basis of the clinical observations, 6 patterns (i.e., sets of limb postures) of upper limb spasticity have been described according to the postures of the shoulder, elbow, forearm, and wrist.

Conclusion: The patterns of upper limb spasticity in patients with multiple sclerosis described by this pilot study do not completely overlap with those observed in patients with post-stroke spasticity. This further supports the need to consider the features of spasticity related to its aetiology in order to manage patients appropriately.

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Published

2024-08-25

How to Cite

Filippetti, M., Lugoboni, L., Di Censo, R., Degli Esposti, L., Facciorusso, S., Varalta, V., … Picelli, A. (2024). Classification of upper limb spasticity patterns in patients with multiple sclerosis: a pilot observational study. Journal of Rehabilitation Medicine, 56, jrm40548. https://doi.org/10.2340/jrm.v56.40548

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Vol. 56 (2024)

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Short Communication

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Copyright (c) 2024 Mirko Filippetti, Linde Lugoboni, Rita Di Censo, Luca Degli Esposti, Salvatore Facciorusso, Valentina Varalta, Andrea Santamato, Massimiliano Calabrese, Nicola Smania, Alessandro Picelli

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