“Perceived spasticity in spinal cord injured patients and its association with psychological factors”

Abstract

Background: Spinal cord injury (SCI) often results in long-term complications, one of the most prevalent being spasticity—a condition characterized by involuntary muscle contractions and increased muscle tone. While spasticity is commonly measured clinically, its perception varies significantly among patients and may be influenced by psychological factors such as depression, anxiety, and stress. Understanding this association is crucial for holistic patient care.Objectives: This study aims to investigate the perceived spasticity in individuals with SCI and its association with psychological factors. Specific objectives include assessing spasticity levels, psychological states, and exploring demographic influences. Methodology: A cross sectional observational study was conducted with 105 SCI patients at the Centre for the Rehabilitation of the Paralysed (CRP), Savar, Bangladesh. Participants were selected based on inclusion/exclusion criteria. Spasticity was assessed using the Modified Ashworth Scale (MAS), while psychological states were measured using the DASS-21 (Depression, Anxiety, and Stress Scale). Data were analyzed using SPSS v25 with chi square tests to explore associations. Results: Findings revealed that most participants had mild to moderate spasticity. A substantial proportion reported psychological distress: 59% had moderate depression, 50.4% had extremely severe anxiety, and 32.4% had mild stress. However, statistical analysis found no significant association between MAS scores and levels of depression, anxiety, or stress. Psychological distress was not significantly influenced by socio-demographic variables either. Discussion: Although spasticity was clinically mild to moderate in most cases, psychological distress was alarmingly high. The lack of a statistical link between clinical spasticity and psychological outcomes highlights the role of subjective perception and emotional factors. These findings support the need for biopsychosocial approaches in SCI rehabilitation. Keywords: Spasticity, Spinal Cord Injury, Depression, Anxiety, Stress, Psychological Factors.