{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T20:51:43Z","timestamp":1793307103040,"version":"4.5.0"},"reference-count":34,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2023,12,23]],"date-time":"2023-12-23T00:00:00Z","timestamp":1703289600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100000738","name":"U.S. Department of Veterans Affairs","doi-asserted-by":"publisher","award":["I01RX002507"],"award-info":[{"award-number":["I01RX002507"]}],"id":[{"id":"10.13039\/100000738","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Mult Scler"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Clinical practice, expert opinion, and evidence-based guidelines recommend daily stretching as first-line treatment for multiple sclerosis (MS) spasticity, but this has not been evaluated by fully powered clinical trials.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To determine whether MS Spasticity: Take Control (STC), a guideline-based program of spasticity education and stretching exercises has different effects on the impact of spasticity than a control program of different spasticity education and range of motion (ROM) exercises.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Ambulatory people with self-reported MS spasticity were randomly assigned to STC or ROM, delivered in same duration, facilitator-led, group classes, face-to-face (F2F) initially and later virtually, due to coronavirus disease 2019 (COVID-19). Multiple Sclerosis Spasticity Scale (MSSS) scores were compared between groups at 1 (primary outcome) and 6 months after interventions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A total of 231 people enrolled. There was no significant difference in MSSS scores between STC and ROM at 1 month (mean difference = 0.28, 95% (confidence interval (CI)) = [\u22129.45 to 10.01], p = 0.955). There were significant group mean improvements in MSSS scores and most other outcomes at 1 and 6 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Education with stretching exercises, the first-line recommended treatment for MS spasticity, and education with ROM exercises may both improve MS spasticity to a similar degree. This study debunks the belief that stretching is essential to managing MS spasticity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/13524585231215960","type":"journal-article","created":{"date-parts":[[2023,12,23]],"date-time":"2023-12-23T04:15:51Z","timestamp":1703304951000},"page":"89-102","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":6,"title":["Stretching is not essential for managing MS spasticity: A randomized controlled trial"],"prefix":"10.1177","volume":"30","author":[{"given":"Cinda L","family":"Hugos","sequence":"first","affiliation":[{"name":"VA Portland Health Care System and Department of Neurology, Oregon Health & Science University, Portland, OR, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra K","family":"Joos","sequence":"additional","affiliation":[{"name":"VA Portland Health Care System, Portland, OR, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne E","family":"Perumean-Chaney","sequence":"additional","affiliation":[{"name":"Biostatistics, University of Alabama, Birmingham, AL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8455-980X","authenticated-orcid":false,"given":"Gary R","family":"Cutter","sequence":"additional","affiliation":[{"name":"Biostatistics, University of Alabama, Birmingham, AL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle H","family":"Cameron","sequence":"additional","affiliation":[{"name":"VA Portland Health Care System and Department of Neurology, Oregon Health & Science University, Portland, OR, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,12,23]]},"reference":[{"key":"bibr1-13524585231215960","doi-asserted-by":"publisher","DOI":"10.1191\/1352458504ms1085oa"},{"key":"bibr2-13524585231215960","unstructured":"Multiple Sclerosis Council for Clinical Practice Guidelines. Spasticity management in multiple sclerosis: Evidence-based management strategies for spasticity treatment in multiple sclerosis. Washington, DC: Paralyzed Veterans of America, 2003, p. 12."},{"key":"bibr3-13524585231215960","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmr.2005.01.006"},{"key":"bibr4-13524585231215960","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2008.02.015"},{"key":"bibr5-13524585231215960","doi-asserted-by":"publisher","DOI":"10.1007\/s10198-013-0537-5"},{"key":"bibr6-13524585231215960","volume":"2003","author":"Shakespeare DT","year":"2003","journal-title":"Cochrane Database Syst Rev"},{"key":"bibr7-13524585231215960","doi-asserted-by":"publisher","DOI":"10.1016\/j.rehab.2017.10.001"},{"key":"bibr8-13524585231215960","doi-asserted-by":"publisher","DOI":"10.3390\/jpm11111074"},{"key":"bibr9-13524585231215960","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2021.03.040"},{"key":"bibr10-13524585231215960","doi-asserted-by":"publisher","DOI":"10.1177\/136140969400800305"},{"key":"bibr11-13524585231215960","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awh675"},{"key":"bibr12-13524585231215960","doi-asserted-by":"publisher","DOI":"10.1186\/s12955-014-0119-y"},{"key":"bibr13-13524585231215960","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinthera.2008.05.011"},{"issue":"1","key":"bibr14-13524585231215960","first-page":"1","volume":"3","author":"Hugos CL","year":"2017","journal-title":"Mult Scler J Exp Transl Clin"},{"key":"bibr15-13524585231215960","volume-title":"Stretching for people with MS: An illustrated manual","author":"Gibson B","year":"2004"},{"key":"bibr16-13524585231215960","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"bibr17-13524585231215960","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.45.2.251"},{"key":"bibr18-13524585231215960","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.60.1.31"},{"key":"bibr19-13524585231215960","doi-asserted-by":"publisher","DOI":"10.1017\/S0317167100048691"},{"key":"bibr20-13524585231215960","doi-asserted-by":"publisher","DOI":"10.1016\/0165-1781(89)90047-4"},{"key":"bibr21-13524585231215960","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2010.04.011"},{"key":"bibr22-13524585231215960","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/124.5.962"},{"key":"bibr23-13524585231215960","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2015.12.031"},{"key":"bibr24-13524585231215960","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000436065.97642.d2"},{"key":"bibr25-13524585231215960","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awn116"},{"key":"bibr26-13524585231215960","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-9993(00)90135-7"},{"key":"bibr27-13524585231215960","doi-asserted-by":"publisher","DOI":"10.3233\/NRE-2009-0486"},{"key":"bibr28-13524585231215960","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2017.00017"},{"key":"bibr29-13524585231215960","doi-asserted-by":"publisher","DOI":"10.1177\/1352458517745723"},{"key":"bibr30-13524585231215960","doi-asserted-by":"publisher","DOI":"10.1177\/13524585211046898"},{"key":"bibr31-13524585231215960","doi-asserted-by":"publisher","DOI":"10.1177\/1352458507078392"},{"key":"bibr32-13524585231215960","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/798285"},{"key":"bibr33-13524585231215960","doi-asserted-by":"publisher","DOI":"10.1191\/026921599677595404"},{"key":"bibr34-13524585231215960","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.2009.177071"}],"container-title":["Multiple Sclerosis Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/13524585231215960","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/13524585231215960","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/13524585231215960","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T04:13:47Z","timestamp":1777695227000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/13524585231215960"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,23]]},"references-count":34,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2024,1]]}},"alternative-id":["10.1177\/13524585231215960"],"URL":"https:\/\/doi.org\/10.1177\/13524585231215960","relation":{},"ISSN":["1352-4585","1477-0970"],"issn-type":[{"value":"1352-4585","type":"print"},{"value":"1477-0970","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,12,23]]}}}