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Spasticity in disorders of consciousness: a behavioral study
F A Thibaut1, C Chatelle, S Wannez
1Coma Science Group, Giga Research, Cyclotron Research Centre and Neurology Department, University and University Hospital of Liège, Liège, Belgium - athibaut@ulg.ac.be.
European Journal of Physical and Rehabilitation Medicine
|November 7, 2014
Summary
Spasticity is prevalent in non-communicative patients with disorders of consciousness, impacting recovery. Early management of spasticity and pain is crucial for improving rehabilitation outcomes and quality of life.
Area of Science:
- Neurology
- Rehabilitation Medicine
- Neuroscience
Background:
- Spasticity frequently complicates severe brain injury, hindering patient rehabilitation and diminishing quality of life.
- Non-communicative patients with disorders of consciousness are particularly vulnerable to spasticity.
- Understanding spasticity's prevalence and correlates is vital for optimizing care.
Purpose of the Study:
- To investigate the prevalence of spasticity in non-communicative patients with disorders of consciousness.
- To evaluate correlations between spasticity and factors like pain, physical therapy frequency, time since insult, and comorbidities.
- To inform better management strategies for spasticity in this patient population.
Main Methods:
- Cross-sectional study conducted at a Belgian University Hospital.
- Included 65 chronic (>3 months post-insult) patients with disorders of consciousness.
- Spasticity assessed using the Modified Ashworth Scale (MAS); pain evaluated with the Nociception Coma Scale-Revised (NCS-R).
Main Results:
- 89% of patients exhibited spasticity (MAS≥1), with 61.5% showing severe spasticity (MAS≥3).
- Spasticity severity correlated positively with time since injury and pain scores (NCS-R).
- A negative correlation was found between spasticity severity and physical therapy frequency.
Conclusions:
- Severe spasticity is common in patients with disorders of consciousness, potentially impeding functional recovery.
- Pain management is critical, given the correlation between spasticity and pain scores.
- Further research into spasticity's relationship with pharmacological and physical therapies is needed to enhance clinical care and patient outcomes.
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