The influence of physiologic and atmospheric variables on spasticity after spinal cord injury

NeuroRehabilitation. 2021;48(3):353-363. doi: 10.3233/NRE-201625.

Abstract

Background: A number of physiological and atmospheric variables are believed to increase spasticity in persons with spinal cord injury (SCI) based on self-reported measures, however, there is limited objective evidence about the influence of these variables on spasticity.

Objective: We investigated the relationship between physiological/ atmospheric variables and level of spasticity in individuals with SCI.

Methods: In 53 participants with motor-incomplete SCI, we assessed the influence of age, time since injury, sex, injury severity, neurological level of injury, ability to walk, antispasmodic medication use, temperature, humidity, and barometric pressure on quadriceps spasticity. Spasticity was assessed using the pendulum test first swing excursion (FSE). To categorize participants based on spasticity severity, we performed cluster analysis. We used multivariate stepwise regression to determine variables associated with spasticity severity level.

Results: Three spasticity groups were identified based on spasticity severity level: low, moderate, and high. The regression analysis revealed that only walking ability and temperature were significantly related to spasticity severity.

Conclusions: These outcomes validate the self-reported perception of people with SCI that low temperatures worsen spasticity. The findings refine prior evidence that people with motor-incomplete SCI have higher levels of spasticity, showing that those with sufficient motor function to walk have the highest levels of spasticity.

Keywords: Paraplegia; spasms; stiffness; temperature; tetraplegia; walking.

MeSH terms

  • Adult
  • Female
  • Humans
  • Male
  • Middle Aged
  • Muscle Spasticity / epidemiology*
  • Quadriceps Muscle / physiopathology
  • Spinal Cord Injuries / complications*
  • Spinal Cord Injuries / physiopathology
  • Walking
  • Weather*