Classification of upper limb spasticity patterns in patients with multiple sclerosis: a pilot observational study

J Rehabil Med. 2024 Aug 25:56:jrm40548. doi: 10.2340/jrm.v56.40548.

Abstract

Objective: The aim of this study was to provide a classification of the upper limb patterns in patients with upper limb spasticity due to multiple sclerosis.

Design: Pilot observational study.

Patients: Twenty-five adult patients with multiple sclerosis suffering from upper limb spasticity who underwent one segmental (i.e., proximal and distal upper limb) botulinum toxin treatment cycle were recruited.

Methods: Patients remained in a sitting position during the evaluation. Upper limb spasticity postures (i.e., postural attitude of a single joint/anatomical region) were evaluated and recorded for the shoulder (adducted/internally rotated), elbow (flexed/extended), forearm (pronated/supinated/neutral), wrist (flexed/extended/neutral) and hand (fingers flexed/thumb in palm).

Results: On the basis of the clinical observations, 6 patterns (i.e., sets of limb postures) of upper limb spasticity have been described according to the postures of the shoulder, elbow, forearm, and wrist.

Conclusion: The patterns of upper limb spasticity in patients with multiple sclerosis described by this pilot study do not completely overlap with those observed in patients with post-stroke spasticity. This further supports the need to consider the features of spasticity related to its aetiology in order to manage patients appropriately.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Female
  • Humans
  • Male
  • Middle Aged
  • Multiple Sclerosis* / complications
  • Multiple Sclerosis* / physiopathology
  • Muscle Spasticity* / etiology
  • Muscle Spasticity* / physiopathology
  • Pilot Projects
  • Posture / physiology
  • Upper Extremity* / physiopathology