J Rehabil Med. 2020 Mar 31;52(3):jrm00037. doi: 10.2340/16501977-2657.
To identify the impact of moderate-to-severe spasticity on functioning in people living with spinal cord injury.
Secondary analysis of cross-sectional survey data using graphical modelling.
Individuals (n = 1,436) with spinal cord injury aged over 16 years with reported spasticity problems.
Spasticity and 13 other impairments in body functions were assessed using the spinal cord injury Secondary Conditions Scale. Impairments in mental functions were assessed using the Mental Health subscale of the 36-item Short Form (SF-36). Independence in activities was measured with the Spinal Cord Injury Independence Measure Self-Report. Restrictions in participation were measured with the Utrecht Scale for Evaluation Rehabilitation - Participation.
Fifty-one percent of participants reported moderate-to-severe spasticity. Graphical modelling showed that Chronic pain, Contractures, Tiredness, Doing housework, and Respiratory functions were associated with spasticity and were the top 5 potential targets for interventions to improve the experience of spasticity. The associations and intervention targets were dependent on the level and completeness of the lesion.
This is the first application of graphical modelling in studying spasticity in people living with spinal cord injury. The results can be used as a basis for studies aiming to optimize rehabilitation interventions in people with moderate-to-severe spasticity.
确定中重度痉挛对脊髓损伤患者功能的影响。
使用图形建模对横断面调查数据进行二次分析。
年龄在 16 岁以上，报告有痉挛问题的脊髓损伤个体（n=1436）。
使用脊髓损伤继发状况量表评估痉挛和 13 种其他身体功能障碍。使用 36 项简短健康调查问卷的心理健康子量表评估精神功能障碍。使用脊髓损伤独立性量表自我报告评估活动独立性。使用乌得勒支康复参与评估量表评估参与受限。
51%的参与者报告有中重度痉挛。图形建模显示，慢性疼痛、挛缩、疲劳、做家务和呼吸功能与痉挛有关，是改善痉挛体验的 5 个潜在干预目标。关联和干预目标取决于损伤的程度和完整性。
这是首次在研究脊髓损伤患者痉挛的研究中应用图形建模。研究结果可作为旨在优化中重度痉挛患者康复干预的研究的基础。
