Stretching is not essential for managing MS spasticity: A randomized controlled trial.

Area of Science:

• Neurology
• Rehabilitation Medicine
• Clinical Trials

Background:

• Clinical guidelines and expert opinion recommend daily stretching for multiple sclerosis (MS) spasticity.
• However, high-powered clinical trials have not yet validated this recommendation.

Purpose of the Study:

• To compare the effectiveness of a guideline-based spasticity education and stretching program (MS Spasticity: Take Control - STC) against a control program (spasticity education and range of motion - ROM exercises).
• To evaluate the impact of these interventions on the severity of MS spasticity.

Main Methods:

• 231 ambulatory individuals with self-reported MS spasticity were randomized into STC or ROM groups.
• Interventions were delivered in group classes, initially face-to-face and later virtually due to COVID-19.
• The primary outcome, Multiple Sclerosis Spasticity Scale (MSSS) scores, was assessed at 1 and 6 months post-intervention.

Main Results:

• No statistically significant difference in MSSS scores was observed between the STC and ROM groups at the 1-month primary endpoint.
• Both groups demonstrated significant mean improvements in MSSS scores and most secondary outcomes at both 1 and 6 months.

Conclusions:

• Education incorporating stretching exercises and education incorporating range of motion exercises may yield similar improvements in MS spasticity.
• The findings suggest that stretching may not be uniquely essential for managing MS spasticity, as other exercise modalities show comparable benefits.