The Miami Project to Cure Paralysis University of Miami, Miami, FL.
Department of Physiology and Biophysics, University of Miami, Miami, FL.
PM R. 2020 Feb;12(2):119-129. doi: 10.1002/pmrj.12218. Epub 2019 Oct 10.
Spasticity and pain frequently co-occur in persons with spinal cord injury (SCI), yet, how these sequelae interact in daily life is unclear. Additionally, little is known about how psychological factors relate to the perception of spasticity and its impacts on daily life.
(1) Characterize relationships between spasticity and chronic pain with regard to perceived severity, difficulty dealing, and life interference. (2) Determine the extent to which perceived spasticity severity and physiological, psychological, and pain-related factors contribute to impacts of spasticity on daily life (difficulty in dealing, life interference). (3) Determine the effects of painful spasticity on aspects of chronic pain and spasticity (severity, life interference, interference with sleep, and spasm duration).
Observational study.
University laboratory.
Twenty participants with SCI and lower extremity spasticity.
Measures included International SCI Pain Basic Data Set, Pain and Spasticity Inventories, Difficulty Dealing with Pain/Spasticity, SCI-Spasticity Evaluation Tool, Connor-Davidson Resilience and Moorong Self-Efficacy Scales, Spinal Cord Assessment Tool for Spastic Reflexes, spasm duration, and injury-related and demographic factors. Bivariate correlations, multiple regression analyses, and pairwise comparisons were performed.
Spasticity and chronic pain were directly related, with respect to perceived severity, difficulty dealing, and life interference (rho = 0.514-0.673, P < .05). Shorter injury duration, greater perceived spasticity severity, and greater difficulty dealing with pain explained 61% of variance in difficulty dealing with spasticity. Greater perceived spasticity severity and lower resilience explained 72% of variance in life interference of spasticity. Spasm duration was not significantly associated with perceived spasticity severity. Participants with painful spasticity had significantly greater chronic pain severity (P = .02) and sleep-related impact of spasticity (P = .03) than participants without painful spasticity.
Perceived severity of spasticity, injury duration, ability to deal with chronic pain, resilience, and painful spasms appear to play important roles in the negative impacts of spasticity on life after SCI.
III.
痉挛和疼痛经常同时出现在脊髓损伤（SCI）患者中，但这些后遗症在日常生活中是如何相互作用的尚不清楚。此外，人们对心理因素如何与痉挛的感知及其对日常生活的影响有关知之甚少。
（1）描述痉挛和慢性疼痛在感知严重程度、处理困难和生活干扰方面的关系。（2）确定感知到的痉挛严重程度以及生理、心理和与疼痛相关的因素在多大程度上影响痉挛对日常生活的影响（处理困难、生活干扰）。（3）确定疼痛性痉挛对慢性疼痛和痉挛的各个方面（严重程度、生活干扰、对睡眠的干扰以及痉挛持续时间）的影响。
观察性研究。
大学实验室。
20 名 SCI 伴有下肢痉挛的患者。
测量包括国际 SCI 疼痛基本数据集、疼痛和痉挛量表、疼痛/痉挛处理困难量表、SCI 痉挛评估工具、Connor-Davidson 韧性和 Moorong 自我效能量表、脊髓反射评估工具、痉挛持续时间以及损伤相关和人口统计学因素。进行了双变量相关性分析、多元回归分析和两两比较。
痉挛和慢性疼痛直接相关，涉及感知严重程度、处理困难和生活干扰（rho=0.514-0.673，P<.05）。损伤持续时间较短、感知到的痉挛严重程度更大以及处理疼痛的困难更大，可解释处理痉挛困难的 61%的方差。感知到的痉挛严重程度和较低的韧性解释了痉挛对生活干扰的 72%的方差。痉挛持续时间与感知到的痉挛严重程度没有显著相关性。有疼痛性痉挛的患者慢性疼痛严重程度显著更高（P=.02），痉挛对睡眠的影响也显著更大（P=.03），而没有疼痛性痉挛的患者则没有这些问题。
感知到的痉挛严重程度、损伤持续时间、处理慢性疼痛的能力、韧性和疼痛性痉挛似乎在 SCI 后痉挛对生活的负面影响中起着重要作用。
III。
