Fluctuations of spasticity in the lower limbs in patients with multiple sclerosis

Abstract

A study of 25 patients with multiple sclerosis was performed to observe fluctuations of spasticity in the lower limbs during the day. Six muscle groups were tested on the left and right side, including the extensors, the adductors and the internal rotators of the hip, the flexors and extensors of the knee and the plantar flexors of the ankle. Spasticity was evaluated in supine position with the Ashworth scale four times during one day between 7.30 a.m. and 8.00 p.m. The data were analysed with the Friedman test. No statistically significant fluctuations in muscle tone were disclosed (α = 0.05) except for the knee extensors on the right side. An additional analysis with statistics of concordance based on the comparison of consecutive scores confirmed the finding that no major changes of spasticity were registered with the Ashworth scale for the 25 patients during the period of testing. The general opinion of clinicians, that spasticity is a variable phenomenon, was not supported statistically by the results of the present study, possibly because of the standardization of the test situation. The fact that standardization of the test situation might be enough to obtain steady scores on the Ashworth scale could be interesting in studies of the effects of treatments on spasticity.