Neuromotor and Cognitive Rehabilitation Research Center, Section of Physical and Rehabilitation Medicine, Department of Neuroscience, Biomedicine, and Movement Sciences, University of Verona, Verona, Italy; Canadian Advances in Neuro-Orthopedics for Spasticity Consortium (CANOSC), Kingston, ON, Canada.
Neuromotor and Cognitive Rehabilitation Research Center, Section of Physical and Rehabilitation Medicine, Department of Neuroscience, Biomedicine, and Movement Sciences, University of Verona, Verona, Italy.
J Rehabil Med. 2024 Aug 25;56:jrm40548. doi: 10.2340/jrm.v56.40548.
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.
Pilot observational study.
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.
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).
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.
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.
本研究旨在对多发性硬化症导致上肢痉挛的患者上肢模式进行分类。
初步观察性研究。
25 名成人多发性硬化症患者，上肢痉挛，接受了一个节段性（即近端和远端上肢）肉毒毒素治疗周期。
患者在评估过程中保持坐姿。评估并记录上肢痉挛姿势（即单个关节/解剖区域的姿势），包括肩部（内收/内旋）、肘部（弯曲/伸展）、前臂（旋前/旋后/中立）、腕部（弯曲/伸展/中立）和手部（手指弯曲/拇指在掌心）。
基于临床观察，根据肩部、肘部、前臂和腕部的姿势，描述了 6 种上肢痉挛模式（即一组肢体姿势）。
本初步研究描述的多发性硬化症患者的上肢痉挛模式与脑卒中后痉挛患者的观察结果不完全重叠。这进一步支持了需要考虑与病因相关的痉挛特征，以便对患者进行适当的管理。
