A randomized controlled pilot trial of a group spasticity management program versus usual care in people with multiple sclerosis
ECTRIMS Online Library. 10/27/17; 200554; P899
Abstract

Abstract: P899

Type: Poster

Abstract Category: Clinical aspects of MS - 7 MS symptoms

Objective: To determine whether group delivery of MS Spasticity: Take Control (STC) is associated with greater changes in spasticity than usual care (UC) in people with multiple sclerosis (MS).
Background: Spasticity affects over 80% of people with MS impacting activity, participation and quality of life. We developed a comprehensive spasticity management program based on an international guideline, including DVDs with education and lower extremity stretching.
Design/methods: Ambulatory MS subjects with self-reported spasticity interfering with daily activities were randomized to STC or UC using a brochure. Subjects completed the MS Spasticity Scale-88 (MSSS), MS Walking Scale (MSWS), Modified Ashworth Scale (MAS) and Timed Up and Go (TUG) at baseline and following 4 weeks of intervention.
Results: 40 subjects were randomized. 38 completed both assessments. Mean MSSS total scores improved more in STC than in UC (STC -27.8, UC -3.7, p< 0.03) and on the MSSS Pain and Discomfort subscale (STC -3.9, UC +0.4, p< 0.02) and MSSS Muscle Spasms subscale (STC -5.1, UC -0.4, p< 0.03). There was no change in MAS. Statistically significant differences were not found on the TUG or the MSWS, but the STC group improved clinically significantly with 21% (p< 0.2) on TUG and 17% (p< 0.3) on MSWS. The UC worsened 10% (p< 0.5) on TUG and 5% (p< 0.3) on MSWS.
Conclusions: Participation in a small group MS spasticity program improved subjective spasticity more than usual care. STC provided encouraging improvement on subjective and functional walking measures compared to UC suggesting benefit of a comprehensive spasticity program to help manage MS-related lower extremity spasticity. Results of this pilot study will be replicated in a fully powered trial.
Disclosure: The project is supported by project number N1401-P from the Rehabilitation Research & Development Service of the VA Office of Research and Development and Oregon Clinical & Translational Research Institute at VA Portland Health Care System and Oregon Health & Science University by NCATS-funded CTSA grant (UL1TR000128).
The authors report no relevant disclosures.

Abstract: P899

Type: Poster

Abstract Category: Clinical aspects of MS - 7 MS symptoms

Objective: To determine whether group delivery of MS Spasticity: Take Control (STC) is associated with greater changes in spasticity than usual care (UC) in people with multiple sclerosis (MS).
Background: Spasticity affects over 80% of people with MS impacting activity, participation and quality of life. We developed a comprehensive spasticity management program based on an international guideline, including DVDs with education and lower extremity stretching.
Design/methods: Ambulatory MS subjects with self-reported spasticity interfering with daily activities were randomized to STC or UC using a brochure. Subjects completed the MS Spasticity Scale-88 (MSSS), MS Walking Scale (MSWS), Modified Ashworth Scale (MAS) and Timed Up and Go (TUG) at baseline and following 4 weeks of intervention.
Results: 40 subjects were randomized. 38 completed both assessments. Mean MSSS total scores improved more in STC than in UC (STC -27.8, UC -3.7, p< 0.03) and on the MSSS Pain and Discomfort subscale (STC -3.9, UC +0.4, p< 0.02) and MSSS Muscle Spasms subscale (STC -5.1, UC -0.4, p< 0.03). There was no change in MAS. Statistically significant differences were not found on the TUG or the MSWS, but the STC group improved clinically significantly with 21% (p< 0.2) on TUG and 17% (p< 0.3) on MSWS. The UC worsened 10% (p< 0.5) on TUG and 5% (p< 0.3) on MSWS.
Conclusions: Participation in a small group MS spasticity program improved subjective spasticity more than usual care. STC provided encouraging improvement on subjective and functional walking measures compared to UC suggesting benefit of a comprehensive spasticity program to help manage MS-related lower extremity spasticity. Results of this pilot study will be replicated in a fully powered trial.
Disclosure: The project is supported by project number N1401-P from the Rehabilitation Research & Development Service of the VA Office of Research and Development and Oregon Clinical & Translational Research Institute at VA Portland Health Care System and Oregon Health & Science University by NCATS-funded CTSA grant (UL1TR000128).
The authors report no relevant disclosures.

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