Individual perception of environmental factors that influence lower limbs spasticity in inherited spastic paraparesis - 21/10/23
Highlights |
• | The clinical heterogeneity of hereditary spastic paraplegia is unpredictable. |
• | Perception of spasticity is modified by intrinsic and extrinsic factors. |
• | Participants report that stressful situations exacerbate spasticity. |
• | Physiotherapy most effectively reduces lower limb spasticity. |
• | Physiotherapy and physical activity should be performed at least 3 times a week. |
Abstract |
Background: Phenotypic variability is a consistent finding in neurogenetics and therefore applicable to hereditary spastic paraparesis. Identifying reasons for this variability is a challenge. We hypothesized that, in addition to genetic modifiers, extrinsic factors influence variability.
Objectives: Our aim was to describe the clinical variability in hereditary spastic paraparesis from the person's perspective. Our goals were to identify individual and environmental factors that influence muscle tone disorders and derive interventions which could improve spasticity.
Methods: This study was based on self-assessments with questions on nominal and ordinal scales completed by participants with hereditary spastic paraparesis. A questionnaire was completed either in-person in the clinic or electronically via lay organization websites.
Results: Among the 325 responders, most had SPG4/SPAST (n = 182, 56%) with a mean age at onset of 31.7 (SD 16.7) years and a mean disease duration of 23 (SD 13.6) years at the time of participation. The 2 factors identified as improving spasticity for > 50% of the responders were physiotherapy (193/325, 59%), and superficial warming (172/308, 55%). Half of the responders (n = 164, 50%) performed physical activity at least once a month and up to once a week. Participants who reported physiotherapy as effective were significantly more satisfied with ≥ 3 sessions per week. Psychologically stressful situations (246/319, 77%) and cold temperatures (202/319, 63%) exacerbated spasticity for most participants.
Conclusion: Participants perceived that physiotherapy reduced spasticity and that the impact of physiotherapy on spasticity was much greater than other medical interventions. Therefore, people should be encouraged to practice physical activity at least 3 times per week. This study reported participants’ opinions: in hereditary spastic paraparesis only functional treatments exist, therefore the participant's expertise is of particular importance.
Le texte complet de cet article est disponible en PDF.Keywords : Spasticity, Physiotherapy, Hereditary spastic paraparesis, Survey, Physical activity, Coping
Abbreviations : HSP, PSQI
Plan
Vol 66 - N° 6
Article 101732- septembre 2023 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.