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Development and validation of Spasticity Index-Amyotrophic Lateral Sclerosis.

K Milinis1, A Tennant2, R J Mills3,4

  • 1Imperial College London, London, UK.

Acta Neurologica Scandinavica
|February 23, 2018
PubMed
Summary

A new Spasticity Index for ALS (SI-ALS) scale was developed for amyotrophic lateral sclerosis (ALS) patients. This validated self-report measure confirms spasticity significantly impacts quality of life and motor function in ALS.

Keywords:
amyotrophic lateral sclerosismotor neurone diseasepatient reported outcome measuresquality of lifespasticity

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Area of Science:

  • Neurology
  • Clinical Measurement
  • Patient-Reported Outcomes

Background:

  • Spasticity is a prevalent and debilitating symptom in amyotrophic lateral sclerosis (ALS).
  • Existing spasticity measures lack ALS-specific validation.
  • There is a need for a reliable, patient-reported outcome measure for spasticity in ALS.

Purpose of the Study:

  • To develop and validate a disease-specific self-report outcome measure for spasticity in ALS patients.
  • To assess the impact of spasticity on quality of life and motor function in ALS.

Main Methods:

  • Development of a draft scale based on semi-structured interviews with ALS patients.
  • Administration of the scale across UK ALS clinics, with Rasch analysis for internal validity.
  • Co-administration of the Numerical Rating Scale (NRS) for spasticity and Leeds Spasticity Scale (LSS).
  • Utilizing the final scale in a path model to examine relationships between spasticity, quality of life, and motor function.

Main Results:

  • A 20-item scale, the Spasticity Index for ALS (SI-ALS), was developed and validated using Rasch analysis.
  • The SI-ALS demonstrated unidimensionality and was free from differential item functioning.
  • Spasticity was reported by 80% of the 465 participating ALS patients.
  • Moderate correlations were observed between SI-ALS, LSS, and NRS-spasticity.
  • Path analysis indicated that greater spasticity negatively impacts quality of life and motor function in ALS.

Conclusions:

  • The Spasticity Index for ALS (SI-ALS) is a robust, disease-specific, interval-level self-report measure for spasticity in ALS.
  • Spasticity significantly affects the quality of life for individuals with ALS.