Spasticity after traumatic spinal cord injury: nature, severity, and location

Arch Phys Med Rehabil. 1999 Dec;80(12):1548-57. doi: 10.1016/s0003-9993(99)90329-5.


Objective: To assess spasticity in a prevalence population of persons with traumatic spinal cord injury (SCI), and determine the degree of correspondence between self-reported spasticity and investigator-elicited spasticity using the modified Ashworth scale.

Design: Survey of a near total (88%) prevalence population.

Setting: Outpatient clinic of a university hospital.

Patients: A total of 354 individuals with SCI.

Main outcome measures: The survey includes self-reported symptoms, neurologic examination (American Spinal Injury Association [ASIA] classification), physical therapy examination, range of motion (ROM), and complications.

Results: Presence of problematic spasticity was significantly correlated with cervical incomplete (ASIA B-D) injury. Reports of beneficial effects of spasticity were significantly less common in women. Self-reported problematic spasticity was significantly correlated with extensor spasticity. Spasticity was elicitable by movement provocation in 60% of the patients reporting spasticity. Significant correlations were found between elicitable spasticity and limited ROM.

Conclusion: Flexion, extension, and abduction movements performed with the patient placed in a standardized supine test position are suitable both for test of ROM and degree of spasticity. Spasticity was not elicitable by movement provocation on physical examination in 40% of the patients who reported spasticity, thus indicating that the patient's self-report is an important complement to the clinical assessment. A significant association between spasticity and contractures (reduced ROM) was seen.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Health Surveys
  • Humans
  • Male
  • Middle Aged
  • Muscle Spasticity / classification
  • Muscle Spasticity / diagnosis*
  • Muscle Spasticity / etiology*
  • Muscle Spasticity / physiopathology
  • Muscle Spasticity / rehabilitation
  • Neurologic Examination
  • Physical Therapy Modalities
  • Prevalence
  • Range of Motion, Articular
  • Severity of Illness Index*
  • Spinal Cord Injuries / complications*
  • Surveys and Questionnaires