多发性硬化症患者痉挛的识别、描述及变异性以及医患对话的潜在障碍:大规模自我报告调查SEEN-MSS的结果
Recognition, Description, and Variability of Spasticity in Individuals With Multiple Sclerosis and Potential Barriers to Clinician-Patient Dialogue: Results From SEEN-MSS, a Large-Scale, Self-Reported Survey.
作者信息
Thrower Ben, Newsome Scott D, Hendin Barry, Danese Sherry, Patterson Jenifer, Chinnapongse Robert
机构信息
From the Andrew C. Carlos Multiple Sclerosis Institute, Shepherd Center, Atlanta, GA (BT).
Johns Hopkins University School of Medicine, Baltimore, MD (SDN).
出版信息
Int J MS Care. 2024 Mar-Apr;26(2):75-80. doi: 10.7224/1537-2073.2022-115. Epub 2024 Mar 11.
BACKGROUND
The experience with spasticity varies among individuals with multiple sclerosis and spasticity (MSS), as they may not recognize it as spasticity or have the language to describe their symptoms. This can lead to potential delays in diagnosis and treatment.
METHODS
Symptoms and Emotions Exploration Needed in Multiple Sclerosis Spasticity was an online survey completed by 1177 individuals with MSS in 2021. It sought to capture symptoms of spasticity, variability of symptoms, specific spasticity triggers, and how conversations with physicians were initiated.
RESULTS
The mean age of the cohort was 56.8 years and it was 78% women. Prior to spasticity onset, 65% of respondents felt minimally prepared or unprepared for possibly developing spasticity and were unaware that spasticity manifests as part of MS. Eighty percent experienced spasticity daily, which was variable in severity and duration. Spasticity was triggered by a range of factors and 90% of those surveyed were unable to predict when it would occur or its severity. Day-to-day variability of spasticity prevented 65% of respondents from doing things they wished to do. Sixty percent were confused by their symptoms, not recognizing them as spasticity. Although 91% reported experiencing muscle spasms, only 69% used "muscle spasms" to describe their symptoms. Other descriptors included "muscle tightness," "stiffness," "cramping," and "pain." After recognizing spasticity, 78% proactively initiated discussions with their physicians, 52% wished they had done so sooner, and 42% delayed the conversation by up to or more than a year.
CONCLUSIONS
Results emphasize the variable nature of spasticity and the lack of a common language to describe symptoms, underscoring the importance of education, earlier recognition, and customized treatments tailored to the severity and duration of spasticity symptoms.
背景
多发性硬化症合并痉挛(MSS)患者对痉挛的体验因人而异,因为他们可能未将其识别为痉挛,或者没有描述症状的语言。这可能导致诊断和治疗的潜在延迟。
方法
多发性硬化症痉挛所需症状与情绪探索是一项于2021年由1177名MSS患者完成的在线调查。该调查旨在获取痉挛症状、症状的变异性、特定的痉挛触发因素,以及与医生的对话是如何开始的。
结果
该队列的平均年龄为56.8岁,女性占78%。在痉挛发作之前,65%的受访者对可能出现的痉挛准备不足或毫无准备,并且不知道痉挛是MS的一部分表现。80%的人每天都经历痉挛,其严重程度和持续时间各不相同。痉挛由一系列因素触发,90%的受访者无法预测痉挛何时会发生或其严重程度。痉挛的日常变异性使65%的受访者无法做他们想做的事情。60%的人对自己的症状感到困惑,未将其识别为痉挛。尽管91%的人报告有肌肉痉挛,但只有69%的人用“肌肉痉挛”来描述他们的症状。其他描述包括“肌肉紧绷”“僵硬”“抽筋”和“疼痛”。在认识到痉挛后,78%的人主动与医生进行了讨论,52%的人希望自己能更早这样做,42%的人将对话推迟了一年或更长时间。
结论
结果强调了痉挛的多变性以及缺乏描述症状的通用语言,凸显了教育、早期识别以及根据痉挛症状的严重程度和持续时间量身定制治疗的重要性。