The role of specialist nurses in detecting spasticity and related symptoms in multiple sclerosis

• Published in: Journal of clinical nursing Vol. 32; no. 13-14; pp. 3496 - 3503
• Main Authors: Artola, Montse, Hernando, Ana, Vidal, Oscar, Vidal, Núria, Cuenca, Ester, Horno, Rosalía, Robles, Miguel Ángel, Oriol, Clara, Peralta, Silvia, Solana, M. A. José, Rubio, Matilde, Montero, Cristina, Lleixà, Mercè, Zabay, Cinta, Martin, Montse, Leon, Isabel, Molinos, Consuelo, Matamoros, Mandi, Mercadé, Laura, Fornali, Olga, Montero, Laura, Saiz, Albert, Solà‐Valls, Núria
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01-07-2023
• Subjects: Activities of Daily Living; Adolescent; Adult; Aged; Cross-Sectional Studies; Disability; Female; Humans; limiting symptoms; Male; Middle Aged; Multiple sclerosis; Multiple Sclerosis - complications; Muscle Spasticity; Nurse Specialists; Nurses; Quality of Life; Spain; Spasticity; specialist nurses; Spain; spasticity; specialist nurses; quality of life; limiting symptoms; multiple sclerosis
• DOI: 10.1111/jocn.16421
• EISSN: 1365-2702
• ISSN: 0962-1067

Background
Spasticity is a frequent symptom of multiple sclerosis (MS), which may negatively influence daily living activities (ADL).
Objectives
To (1) explore the feasibility to conduct a structured interview by specialist nurses about limitations in ADL; (2) determine the percentage of people with MS (PwMS) with limitations in ADL related to spasticity; (3) to assess the knowledge about spasticity and describe its clinical features.
Design
Observational, cross‐sectional, multicentre study in 16 MS units of Catalonia (Spain). Participants were recruited from the outpatient facility and day‐care hospital between July 2018 and June 2019 and met the following criteria: (1) age 18 or older, (2) diagnosis of MS according to McDonald criteria 2010 and (3) no clinical relapse in previous 30 days.
Methods
Specialist nurses conducted a structured interview divided in two parts: the assessment of (1) limitations in the ADL and (2) the presence of spasticity and associated symptoms. The usefulness of this intervention was requested. This study met the STROBE reporting guidelines checklist for observational studies.
Results
Three hundred sixty eight pwMS (244 women) with a mean age of 46 years and a median Expanded Disability Status Scale score of 2.5 (range, 0–8.5) were included. 262 (71%) pwMS had limitations in the ADL, and spasticity was reported as the most limiting symptom in 59 (23%). As a result of the interview, spasticity was observed in 199 (76%) participants; 47 (24%) of them were unaware that they had spasticity and 102 (51%) would not have reported it spontaneously. The level of the interview satisfaction was high (90%).
Conclusions
Spasticity is a complex and limiting symptom in MS. The structured interview conducted by specialist nurses is feasible and has good acceptance.
Patient contribution
Specialist nurses can be proactive in MS clinical assessment, which may help to detect symptoms with negative impact on quality of life.