Öznur Buran Sevik
Hospital Universitario Donostia, Physical Medicine and Rehabilitation Department, San Sebastian, Spain
Juan Pablo Moncada Zapata
Universidad de Caldas, Manizales, Colombia
Ashwini Mahadevaiah
Harvard University, T. H. Chan School of Public Health, ECPE-PPCR Boston, USA
Talita Peixoto Pinto
Instituto D’Or de Pesquisa e Ensino (IDOR), Rio de Janeiro, Brazil
Fatima Al Sada
Hamad Medical Corporation, Doha, Qatar
Gustavo Coy
Otolaryngology Department, Pontifical Catholic University of Campinas, São Paulo, Brazil
Carlos de Almeida Obregon
Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil
Vitor Dias de Almeida
Federal University of São Paulo, São Paulo, Brazil
Melanie Duran
Harvard University, T. H. Chan School of Public Health, ECPE-PPCR Boston, USA
Kaique Flávio Xavier Cardoso Filardi
Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil
Gregor Gierlinger
Medical Faculty, Johannes Kepler University Linz, Linz, Austria
Marcelo Gomes Davanço
Medical Department, Adium S.A., São Paulo, Brazil
Tatiana Gomez Gomez
Dr. Phillip Frost Department of Dermatology & Cutaneous Surgery, University of Miami, Miami, FL, USA
Roberta Rossi Grudtner
Secretaria Estadual da Saúde, Rio Grande do Sul, Brazil
Raphael Federicci Haddad
Hospital Israelita Albert Einstein, São Paulo, Brazil
Ahmed Humaida
Prince Mohammed bin Abdelaziz Hospital, National Guard Health Affairs, Saudi Arabia, Madinah Munawarah
Julia Husman
Department of Medicine, University Hospital Carl Gustav Carus Dresden, TU Dresden, Germany
Greta Jurenaite
Italian Scientific Spine Institute (ISICO), Milan, Italy
Cindy Bustamante
Clínica Dávila, Santiago, Chile
Maria Luisa Mathias Machado
Escola Bahiana de Medicina e Saúde Pública (EBMSP), Bahia, Brazil
Edith Berenice Martinez-Lozano
Musculoskeletal Translational Innovation Initiative, Carl J. Shapiro, Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
Raelson Rodrigues Miranda
Instituto do Câncer de São Paulo (ICESP), São Paulo, Brazil
Ana Luisa Peralta
Hospital Metropolitano de Santiago (HOMS), Santiago de los Caballeros, Dominican Republic
Inia Andrea Perez Villa
Infectious Disease Unit, Internal Medicine Department, Clinica Alemana de Santiago, Chile
Carina Carraro Pessoa
Instituto de Pesquisa Hapvida NotreDame Intermedica, São Paulo, Brazil
Angie Pichardo
Pontificia Universidad Católica Madre y Maestra, Santiago de los Caballeros, Dominican Republic
Angel Leonardo Rodriguez
Pontificia Universidad Católica Madre y Maestra, Santiago de los Caballeros, Dominican Republic
Viviana Ugenti
Anesthesia Section, University Hospital Clementino Fraga Filho, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
Abstract
Background: Spasticity is a core clinical presentation of Multiple Sclerosis, associated with disease progression, significantly
affecting patients’ and caregivers’ quality of life. Numerous clinical scales have been developed to assess the impact and
severity of spasticity in patients with Multiple Sclerosis. Yet, a consensus on the best tool still needs to be reached.
Objective: To provide an overview of the clinical scales most often used when studying spasticity in Multiple Sclerosis,
including studies utilizing these tools.
Methods: We extensively searched the MEDLINE (PubMed) database; articles published in English between November
2003 and July 2023 were included. We utilized the Cochrane’s Methods Executive tools for bias assessment. The extracted
data was synthesized to provide a comprehensive overview of the current evidence about the clinical scales used to assess
and quantify muscle spasticity in MS.
Results: The final analysis included 13 articles. Six studies focused on the assessment of spasticity scales. The remaining
articles involved interventions and observational studies. The Modified Ashworth Scale and Ashworth Scale were the most
frequently used scales (38.4
Discussion: Quantifying spasticity by clinical scales is necessary for correct grading and evaluation of treatment responses.
The studies selected for this review showed significant variability in the spasticity measure scales utilized. The most
prevalent choices were the MAS and AS, independently used or combined with other tools. A detailed rationale for the
choice of scale was absent in all of the included studies. Further research is crucial to determine the most suitable scale for
assessing spasticity in multiple sclerosis in the setting of clinical research.
