Neck muscle spasticity in patients with disorder of consciousness: a pilot study.
Valeria Pingue, Marta Mirando, Benedetta Cazzulani and 4 others
PMID 38502553WHAT IT FOUND
Neck spasticity is very common in patients with severe brain injury and disorders of consciousness, affecting 91.7% of those studied.
In patients who are unresponsive, severe neck stiffness predicted worse neurological and functional recovery after six months of rehabilitation.
Key findings
01Neck muscle spasticity was present in 91.7% of patients with disorders of consciousness, despite most already receiving antispastic medication.
02In patients with unresponsive wakefulness syndrome, severe neck spasticity was an independent predictor of worse neurological and functional outcomes at discharge.
03Patients with traumatic brain injury presented with more severe neck muscle spasticity than those with non-traumatic injuries.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
This was a pilot study with a small sample size (48 patients). The design cannot determine cause and effect between spasticity and outcomes. The study did not evaluate the effects of treatments (pharmacological or physical therapy) on spasticity. Most patients were already on antispastic medication, which may have influenced the severity of observed spasticity. The Functional Independence Measure may have had a 'floor effect' in these severely impaired patients, potentially masking differences in outcomes.
Declared interests
The authors declared no conflicts of interest. The work was partially funded by the Italian Ministry of Health under 'Ricerca Corrente' schemes.
The easy way to misread this
Do not assume that neck spasticity predicts poor outcomes in all patients with disorders of consciousness. This association was found only in those with unresponsive wakefulness syndrome, not in those with a minimally conscious state.