BACKGROUND Spasticity is a common feature in patients with disruptions in corticospinal pathways. However, the term is used ambiguously. Here, spasticity is defined as enhanced velocity-dependent stretch reflexes and placed within the context of deforming spastic paresis encompassing other forms of muscle overactivity. OBJECTIVE This scoping review aims at evaluating the clinimetric quality of clinical outcome assessments (COAs) for spasticity across different pathologies and to make recommendations for their use. METHODS A literature search was conducted to identify COAs used to assess spasticity. An international expert panel evaluated the measurement properties in the included COAs. Recommendations were based on the MDS-COA program methodology based on three criteria: if the COA was (1) applied to patients with spastic paresis, (2) used by others beyond the developers, and (3) determined to be reliable, valid, and sensitive to change in patients with spasticity. RESULTS We identified 72 COAs of which 17 clinician-reported outcomes (ClinROs) and 6 patient-reported outcomes (PROs) were reviewed. The Tardieu Scale was the only ClinRO recommended for assessing spasticity. One ClinRO-Composite Spasticity Index-and two PROs-Spasticity 0-10 Numeric Rating Scale and 88-Item Multiple Sclerosis Spasticity Scale-were recommended with caveats. The Ashworth-derived COAs were excluded after evaluation due to their focus on muscle tone rather than spasticity, as defined in this review. CONCLUSIONS The Tardieu Scale is recommended for assessing spasticity, and two PROs are recommended with caveats. Consistent terminology about the various types of muscle overactivity is necessary to facilitate their assessment and treatment. © 2024 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

中文翻译：

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痉挛的临床结果评估：审查、批评和建议。


背景 痉挛是皮质脊髓通路中断患者的共同特征。但是，该术语的使用模棱两可。在这里，痉挛被定义为增强的速度依赖性牵张反射，并被置于变形痉挛性麻痹的背景下，包括其他形式的肌肉过度活跃。目的 本范围综述旨在评估不同病理痉挛状态的临床结果评估 （COA） 的临床质量，并为其使用提出建议。方法 进行文献检索以确定用于评估痉挛状态的 COA。一个国际专家小组评估了所包含的 COA 中的测量特性。建议基于 MDS-COA 计划方法，基于三个标准：如果 COA （1） 应用于痉挛性麻痹患者，（2） 被开发人员以外的其他人使用，以及 （3） 确定可靠、有效且对痉挛患者的变化敏感。结果 我们确定了 72 例 COA，其中 17 例临床医生报告结局 （ClinROs） 和 6 例患者报告结局 （PROs） 被回顾。Tardieu 量表是唯一推荐用于评估痉挛状态的 ClinRO。推荐了一个 ClinRO-综合痉挛指数--和两个 PROs-痉挛 0-10 数字评定量表和 88 项多发性硬化症痉挛量表--但有注意事项。Ashworth 衍生的 COAs 在评估后被排除在外，因为它们关注肌肉张力而不是本综述中定义的痉挛状态。结论 推荐使用 Tardieu 量表来评估痉挛状态，推荐使用两个 PRO 并提出警告。关于各种类型的肌肉过度活动症的一致术语对于促进其评估和治疗是必要的。© 2024 作者。 由 Wiley Periodicals LLC 代表国际帕金森和运动障碍协会出版的《运动障碍》。