Perceived spasticity in chronic spinal cord injured patients: associations with psychological factors.

PURPOSE To explore the association between perceived spasticity and psychological factors (pain sensations, coping strategies, and illness cognitions) in chronic spinal cord injured (SCI) patients. METHODS Cross-sectional study using a set of questionnaires was designed for chronic complete patients with SCI and with self-reported leg spasticity. Outcome measures were Visual Analogue Scale for average perceived leg spasticity (VAS(Spasticity)), VAS(Pain) for average perceived pain sensations in the leg, Utrecht Coping List (UCL) including its seven subscales, and Illness Cognition Questionnaire (ICQ) with its three subscales. Psychological factors with a bivariate correlation with VAS(Spasticity) of p < 0.2 were selected for regression analyses. RESULTS Nineteen patients with SCI (response rate 86%) participated. Bivariate correlations of p < 0.2 were found between VAS(Spasticity) and VAS(Pain), UCL(Active approach), UCL(Seeking social support), UCL(Reassuring thoughts), ICQ(Acceptation), and ICQ(Helplessness). Only UCL(Reassuring) (thoughts) (Beta -0.59, p = 0.01) and ICQ(Helplessness) (Beta 0.50, p = 0.02) were retained in the multivariate model, explaining 44% of the variance in VAS(Spasticity) (R(2)(adjusted)). CONCLUSIONS Perceived spasticity appeared associated with psychological factors in complete patients with SCI: Those with higher levels of reassuring thoughts and lower levels of helplessness reported relatively lower levels of perceived spasticity. Large prospective cohort studies are recommended.