Research: Spasticity; neuros need to listen

Epub: Morley et al. The meaning of spasticity to people with multiple sclerosis: What can health professionals learn? Disabil Rehabil. 2013 Feb.

Purpose: Multiple sclerosis (MS) is the most common disabling neurological condition affecting young adults. One third of people on an American registry of people with MS (PWMS) reported having activities affected by spasticity. The psychosocial effects of spasticity in people with MS have been shown to be distressing and detrimental to emotional and social relationships when investigated from a psychology perspective. This paper investigates the impact of spasticity on the lives of people living with MS from a physiotherapeutic perspective. 

Method: This study involved 12 semi-structured interviews with individuals experiencing MS-related spasticity. Ten sets of data were analyzed following framework analysis principles. 

Results: Results suggest spasticity effects life experience of these PWMS in diverse and complex ways. Physical, psychological and social consequences of spasticity are closely linked and can be far reaching. 

Conclusions: Therapists need to be aware of links between specific physical symptoms and their psychosocial consequences if they want to improve peoples' quality of life. This paper provides in depth qualitative research evidence for the complexity of the spasticity experience for each individual, strengthening the argument for a patient-centred approach to treatment. These results also support the case for targeted interventions with effectiveness recorded in a patient-centred way.

For many years spasticity has been assessed by the neuro, nurse or physiotherapist and looks at different muscle groups and scores whether they were stiff or not, using something called the Ashworth Scale (See Above). Could have been called the jobsworth scale, because it is very unresponsive to therapy and so in trials looking at the effects of medical cannabis, it was found that there was little evidence for change. Therefore the neuro had to tour round the talks circuit telling us why it did not work. However, had they listened to the MSers they said it worked. Now in this paper the Neuros are listening and have devised a new way to look at MS. As a consequence sativex became a licensed drug and because they based their efficacy results on what Msers said and not what Neuros thought. This study says just that Neuros need to listen to MSers. 

CoI: Prof B has developed a drug to treat spasticity and is trying to develop it for the use in MSers