The spasticity-related quality of life 6-dimensions instrument in upper-limb spasticity: Part II A first psychometric evaluation


  • Lynne Turner-Stokes Regional Rehabilitation Unit, Northwick Park Hospital, Watford Road, Harrow, Middlesex, HA1 3UJ, UK
  • Klemens Fheodoroff
  • Jorge Jacinto
  • Jeremy Lambert
  • Christine De La Loge
  • Françoise Calvi-Gries
  • John Whalen
  • Andreas Lysandropoulos
  • Pascal Maisonobe
  • Stephen Ashford



psychometrics, upper extremity, central nervous system diseases, muscle spasticity, quality of life


Objective: Psychometric evaluation of the Spasticity-related Quality of Life 6-Dimensions instrument (SQoL-6D).

Design: A clinimetric evaluation conducted in a multicentre, prospective, longitudinal cohort study at 8 UK sites.

Patients: Adult patients (n=104) undergoing focal treatment of upper-limb spasticity.

Methods: The SQoL-6D was administered in the clinic at enrolment and at 8 weeks, then 1–4 days later at home to assess test-retest reliability.

Results: The SQoL-6D demonstrated adequate construct validity and unidimensionality of the scale, allowing the calculation of a Total score. Cronbach’s alpha (0.74) supported the internal consistency reliability, while the intraclass correlation coefficient supported test-retest reliability (0.82). Correlation coefficients with established instruments supported convergent validity, while significant differences between known-groups (of differing clinical severity) in SQoL-6D Total score confirmed its sensitivity to both cross-sectional and longitudinal differences.

Conclusion: The SQoL-6D is a promising new measure to assess health status for patients with upper-limb spasticity of any aetiology. Further investigation and exploration of the allocation of weights to convert the SQoL-6D to a health-related quality of life utility index, are required.


Lay Abstract

In upper-limb spasticity, the use of the arm and hand become restricted due to “tight” muscles. Although questionnaires to assess a person’s quality of life have been developed, they do not specifically assess the impact of upper-limb spasticity. To address this deficiency, the Spasticity-related Quality of Life 6-Dimensions (SQoL-6D) questionnaire was developed (see also the companion “development” paper available in this issue). To test that the SQoL-6D works as expected, it was completed by 104 people living with spasticity and compared with other questionnaires they completed. The results show that the SQoL-6D questions are relevant to people with spasticity. The answers were reliable when the SQoL-6D was repeated, and differences in the burden of spasticity between people grouped by the severity of their condition were captured accurately. The SQoL-6D is a promising new measure to assess aspects of quality of life in people living with spasticity.


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How to Cite

Turner-Stokes, L., Fheodoroff, K., Jacinto, J., Lambert, J., De La Loge, C., Calvi-Gries, F., Whalen, J., Lysandropoulos, A., Maisonobe, P., & Ashford, S. (2022). The spasticity-related quality of life 6-dimensions instrument in upper-limb spasticity: Part II A first psychometric evaluation. Journal of Rehabilitation Medicine, 54, jrm00243.



Original Report