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Spasticity underdiagnosed

Mar. 24, 2020, 8:30 AM

by Paul Govern

A study of 209 residents of a single nursing home found 45 cases of spasticity but only five previously documented cases, indicating considerable prevalence (22%) and woeful underdiagnosis.

For the authors, Chandler Gill, MD, Mallory Hacker, PhD, MSCI, David Charles, MD, and colleagues, the findings raise the specter of endemic underdiagnosis and undertreatment of spasticity. To the authors’ knowledge this is the first study of the overall prevalence of spasticity in a nursing home population.

A consequence of stroke and other disorders of the central nervous system, spasticity involves the loss of inhibition of motor neurons, resulting in abnormal limb positions, weakness, slow movement and loss of dexterity. Specialist training greatly benefits diagnosis of spasticity, the authors note. While there is no cure, several therapies are available to help with symptoms.

The study, appearing in the Journal of the American Medical Directors Association, also found that spasticity contributed to resident dependency on caregivers for activities of daily living.

Gill is with Rush University Medical Center in Chicago and Hacker and Charles are with Vanderbilt University Medical Center. Joining them in the study were VUMC colleagues Jacqueline Meystedt, Maxim Turchan, MS, John Schnelle, PhD, Sandra Simmons, PhD, MS, Ralf Habermann, MD, MMgt, and Fenna Phibbs, MD, MPH. The study was supported in part by drug maker Allergan, Inc.

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