Identifying and classifying quality of life tools for assessing spasticity after spinal cord injury.

OBJECTIVE: To identify and classify tools for assessing the influence of spasticity on quality of life (QOL) after spinal cord injury (SCI).

METHODS: Electronic databases (MEDLINE/PubMed CINAHL and PsycInfo) were searched for studies published between 1975 and 2012. Dijkers's theoretical framework on QOL was used to classify tools as either objective or subjective measures of QOL.

RESULTS: Sixteen studies met the inclusion criteria. Identified objective measures that were used to assess the influence of spasticity on QOL included the Short Form-36 (SF-36) the Sickness Impact Profile (SIP) and the Health Utilities Index-III (HUI-III). Subjective measures included the Quality of Life Index-SCI Version III (QLI-SCI) Life Situation Questionnaire-Revised (LSQ-R) Reciprocal Support Scale (RSS) Profile of Mood States (POMS) Spinal Cord Injury Spasticity Evaluation Tool (SCI-SET) and the Patient Reported Impact of Spasticity Measure (PRISM). A number of tools proved either to be insensitive to the presence of spasticity (QLI-SCI) or yielded mixed (SF-36) or weak (RSS LSQ-R) results. Tools that were sensitive to spasticity had limited psychometric data for use in the SCI population (HUI-III SIP POMS) although 2 were developed specifically for assessing spasticity on daily life post SCI (SCI-SET PRISM).

CONCLUSIONS: Two condition-specific subjective measures the SCI-SET and PRISM emerged as the most promising tools for the assessment of spasticity impact on QOL after SCI. Further research should focus on establishing the psychometric properties of these measures for use in the SCI population.Key words: outcome measurement quality of life spasticity spinal cord injury.