Assessment and Activity-based Management of Spasticity After Spinal Cord Injury

Abstract

<p>Sixty-five to 78% of sample populations of individuals with chronic spinal cord injury (SCI) have symptoms of spasticity, but current assessment tools and management strategies are inadequate. Therefore, the purpose of this thesis was to: 1) conduct a review of the definition, pathophysiology, and management of symptoms of spasticity in individuals with SCI, 2) develop and assess a new self-report scale designed to measure the impact of spasticity on daily life in people with SCI and 3) examine the effects of body-weight supported treadmill training (BWSTT) and tilt-table standing (TTS) on spasticity outcomes. 1) Spasticity was found to be a relevant concern for the SCI population and possibly responsive to activity-based intervention. A need was identified, however, for an assessment tool that allows individuals with SCI to report the impact of their spasticity. 2) In total, 89 individuals with chronic SCI participated in three phases of scale design: development, pilot testing, and evaluation of test-retest reliability and construct validity. The Spinal Cord Injury Spasticity Evaluation Tool (SCI-SET) was developed as a 7 -day recall self-report questionnaire that takes into account both the problematic and useful effects of spasticity. The internal consistency (a) and intraclass correlation coefficient of the SCI-SET were 0.90 and 0.91, respectively. Construct validity was supported by correlations (r=-0.48 to 0.68; p</p>