Perceived spasticity in chronic spinal cord injured patients: Associations with psychological factors

Abstract

Purpose. To explore the association between perceived spasticity and psychological factors (pain sensations, coping strategies, and illness cognitions) in chronic spinal cord injured (SCI) patients.

Methods. Cross-sectional study using a set of questionnaires was designed for chronic complete patients with SCI and with self-reported leg spasticity. Outcome measures were Visual Analogue Scale for average perceived leg spasticity (VAS_Spasticity), VAS_Pain for average perceived pain sensations in the leg, Utrecht Coping List (UCL) including its seven subscales, and Illness Cognition Questionnaire (ICQ) with its three subscales. Psychological factors with a bivariate correlation with VAS_Spasticity of p < 0.2 were selected for regression analyses.

Results. Nineteen patients with SCI (response rate 86%) participated. Bivariate correlations of p < 0.2 were found between VAS_Spasticity and VAS_Pain, UCL_{Active approach}, UCL_{Seeking social support}, UCL_{Reassuring thoughts}, ICQ_Acceptation, and ICQ_Helplessness. Only UCL_{Reassuring thoughts} (Beta −0.59, p = 0.01) and ICQ_Helplessness (Beta 0.50, p = 0.02) were retained in the multivariate model, explaining 44% of the variance in VAS_Spasticity (R²_adjusted).

Conclusions. Perceived spasticity appeared associated with psychological factors in complete patients with SCI: Those with higher levels of reassuring thoughts and lower levels of helplessness reported relatively lower levels of perceived spasticity. Large prospective cohort studies are recommended.

Keywords:

• Spinal cord injury
• spasticity
• helplessness
• reassuring thoughts

Acknowledgement

This work is part of the Freeband AWARENESS project (http://awareness.freeband.nl). Freeband is sponsored by the Dutch government under contract BSIK 03025.