Journal of Rehabilitation Medicine (Aug 2024)

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

  • Mirko Filippetti,
  • Linde Lugoboni,
  • Rita Di Censo,
  • Luca Degli Esposti,
  • Salvatore Facciorusso,
  • Valentina Varalta,
  • Andrea Santamato,
  • Massimiliano Calabrese,
  • Nicola Smania,
  • Alessandro Picelli

DOI
https://doi.org/10.2340/jrm.v56.40548
Journal volume & issue
Vol. 56

Abstract

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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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