Journal of Rehabilitation Research & Development (JRRD)

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Volume 51 Number 6, 2014
   Pages 975 — 984

Abstract — Dynamometer-based measure of spasticity confirms limited association between plantarflexor spasticity and walking function in persons with multiple sclerosis

Theodore R. Kremer, BS;1 Linda R. Van Dillen, PT, PhD;2 Joanne M. Wagner, PT, PhD3*

1School of Medicine, Saint Louis University, St. Louis, MO; 2Program in Physical Therapy, Washington University School of Medicine, St. Louis, MO; 3Department of Physical Therapy and Athletic Training, Doisy College of Health Sciences, Saint Louis University, St. Louis, MO

Abstract — The literature shows inconsistent evidence regarding the association between clinically assessed plantarflexor (PF) spasticity and walking function in ambulatory persons with multiple sclerosis (pwMS). The use of a dynamometer-based spasticity measure (DSM) may help to clarify this association. Our cohort included 42 pwMS (27 female, 15 male; age: 42.9 +/– 10.2 yr) with mild clinical disability (Expanded Disability Status Scale score: 3.6 +/– 1.6). PF spasticity was assessed using a clinical measure, the modified Ashworth Scale (MAS), and an instrumented measure, the DSM. Walking function was assessed by the timed 25-foot walk test (T25FWT), the 6-minute walk test (6MWT), and the 12-item Multiple Sclerosis Walking Scale (MSWS-12). Spearman rho correlations were used to evaluate relationships between spasticity measures, measures of walking speed and endurance, and self-perceived limitations in walking. The correlation was small between PF spasticity and the T25FWT (PF maximum [Max] MAS rho = 0.27, PF Max DSM rho = 0.26), the 6MWT (PF Max MAS rho = 0.20, PF Max DSM rho = 0.21), and the MSWS-12 (PF Max MAS rho = 0.11, PF Max DSM rho = 0.26). Our results are similar to reports in other neurologic clinical populations, wherein spasticity has a limited association with walking dysfunction.

Key words: 12-item Multiple Sclerosis Walking Scale, ambulation, dynamometer, modified Ashworth Scale, multiple sclerosis, self-perceived limitations, spasticity, walking dysfunction, walking endurance, walking speed.


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This article and any supplementary material should be cited as follows:
Kremer TR, Van Dillen LR, Wagner JM. Dynamometer-based measure of spasticity confirms limited association between plantarflexor spasticity and walking function in persons with multiple sclerosis. J Rehabil Res Dev. 2014; 51(6):975–84.
http://dx.doi.org/10.1682/JRRD.2013.08.0186
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