Spasticity in multiple sclerosis: Associations with impairments and overall quality of life

- Spasticity affects up to 85% of patients with multiple sclerosis.
- After adjusting for confounders spasticity was found to be an independent determinant of worse quality of life in multiple sclerosis.
- There is a strong association between spasticity and fatigue, depression, anxiety, pain and bladder problems.
- Effective pharmacological and non-pharmacological treatments of spasticity are needed to improve the quality of life of patients with multiple sclerosis.

Objectives(1)To determine the association between spasticity and quality of life (QOL) in multiple sclerosis (MS).(2)To investigate the associations between spasticity and impairments of function and activity limitations.DesignCross-sectional survey.SettingA convenience sample of people with MS routinely attending an appointment with their local MS service.Participants701 patients with clinically definite MS.Main outcome measuresDemographic details were obtained and patients completed a battery of measures including spasticity (Multiple Sclerosis Spasticity Scale - 88), fatigue (Neurological Fatigue Index - MS), urinary dysfunction (Qualiveen-SF), pain (Neuropathic Pain Scale), mood disorder (Hospital Anxiety and Depression Scale), disability (World Health Organisation Disability Assessment Schedule) and QOL (Leeds Multiple Sclerosis QOL Scale).Results85.7% of patients reported spasticity. Patients with higher levels of spasticity were more likely to be disabled, suffer from depression and anxiety, have higher levels of fatigue and report more pain and bladder problems (p<0.01). Spasticity remained as a significant direct effect upon QOL in a multivariate model adjusted for other impairments, activity limitation and depression.ConclusionsThere is a strong association between spasticity and fatigue, depression, anxiety, pain and bladder problems. The retention of a significant direct relationship with QOL in a multivariate model emphasises its influence upon the everyday lives of people with MS.