Classification of Upper and Lower Limb Spasticity Patterns and Their Impact on Quality of Life in Patients With Multiple Sclerosis

Summary

Multiple sclerosis (MS) is a chronic neurological disease frequently associated with spasticity, which may lead to functional limitations and reduced quality of life. Although spasticity is common in MS, detailed descriptions of upper and lower extremity spasticity patterns are limited. A better understanding of spasticity patterns may help improve individualized rehabilitation and treatment planning. The aim of this study is to classify upper and lower extremity spasticity patterns in patients with multiple sclerosis and to investigate their association with quality of life. Adult patients with MS and clinical spasticity will be recruited from a tertiary care outpatient clinic. Spasticity will be evaluated using the Modified Ashworth Scale, and extremity postures will be recorded to define spasticity patterns. Functional performance will be assessed using the Timed 25-Foot Walk Test and the 9-Hole Peg Test. The impact of spasticity on quality of life will be evaluated using the Patient-Reported Impact of Spasticity Measure (PRISM). This prospective cross-sectional study is designed to provide a systematic description of spasticity patterns in patients with multiple sclerosis and to examine their relationship with functional outcomes and quality of life.

Eligibility

Inclusion Criteria:

* Diagnosis of multiple sclerosis according to the 2024 McDonald criteria
* Age ≥ 18 years
* Presence of clinical spasticity defined as Modified Ashworth Scale score ≥ 1 in at least one joint
* Ability to understand study procedures and provide informed consent
* Absence of significant cognitive impairment

Exclusion Criteria:

* Presence of orthopedic, rheumatologic, or neurological conditions affecting movement other than multiple sclerosis
* Botulinum toxin type A injection within the previous 3 months
* Previous surgical treatment for upper extremity spasticity
* Bone deformities affecting the upper extremity
* Inability or unwillingness to provide informed consent
* Presence of cognitive impairment

Conditions3

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