{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T11:23:24Z","timestamp":1789039404908,"version":"build-2803163510"},"reference-count":35,"publisher":"MJS Publishing, Medical Journals Sweden AB","license":[{"start":{"date-parts":[[2024,8,25]],"date-time":"2024-08-25T00:00:00Z","timestamp":1724544000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100007366","name":"Fondazione Italiana Sclerosi Multipla","doi-asserted-by":"publisher","award":["2022\/R-Single\/031"],"award-info":[{"award-number":["2022\/R-Single\/031"]}],"id":[{"id":"10.13039\/100007366","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JRM"],"abstract":"<jats:p>Objective: The aim of this study was to provide a classification of the upper limb patterns in patients with upper limb spasticity due to multiple sclerosis.\nDesign: Pilot observational study.\nPatients: Twenty-five adult patients with multiple sclerosis suffering from upper limb spasticity who underwent one segmental (i.e., proximal and distal upper limb) botulinum toxin treatment cycle were recruited.\nMethods: Patients remained in a sitting position during the evaluation. Upper limb spasticity postures (i.e., postural attitude of a single joint\/anatomical region) were evaluated and recorded for the shoulder (adducted\/internally rotated), elbow (flexed\/extended), forearm (pronated\/supinated\/neutral), wrist (flexed\/extended\/neutral) and hand (fingers flexed\/thumb in palm).\nResults: On the basis of the clinical observations, 6\u00a0patterns (i.e., sets of limb postures) of upper limb spasticity have been described according to the postures of the shoulder, elbow, forearm, and wrist.\nConclusion: The patterns of upper limb spasticity in patients with multiple sclerosis described by this pilot study do not completely overlap with those observed in patients with post-stroke spasticity. This further supports the need to consider the features of spasticity related to its aetiology in order to manage patients appropriately.<\/jats:p>","DOI":"10.2340\/jrm.v56.40548","type":"journal-article","created":{"date-parts":[[2024,8,26]],"date-time":"2024-08-26T06:24:53Z","timestamp":1724653493000},"page":"jrm40548","source":"Crossref","is-referenced-by-count":6,"title":["Classification of upper limb spasticity patterns in patients with multiple sclerosis: a pilot observational study"],"prefix":"10.2340","volume":"56","author":[{"given":"Mirko","family":"Filippetti","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linde","family":"Lugoboni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rita","family":"Di Censo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Degli Esposti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salvatore","family":"Facciorusso","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Varalta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Santamato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimiliano","family":"Calabrese","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Smania","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Picelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1183","published-online":{"date-parts":[[2024,8,25]]},"reference":[{"key":"72570","doi-asserted-by":"crossref","unstructured":"Kamm CP, Uitdehaag BM, Polman CH. Multiple sclerosis: current knowledge and future outlook. Eur Neurol 2014; 72: 132-141.","DOI":"10.1159\/000360528"},{"key":"72571","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1159\/000360528","DOI":"10.1159\/000360528"},{"key":"72572","doi-asserted-by":"crossref","unstructured":"Noseworthy JH, Lucchinetti C, Rodriguez M, Weinshenker BG. Multiple sclerosis. N Engl J Med 2000; 343: 938-952.","DOI":"10.1056\/NEJM200009283431307"},{"key":"72573","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1056\/NEJM200009283431307","DOI":"10.1056\/NEJM200009283431307"},{"key":"72574","doi-asserted-by":"crossref","unstructured":"Cattaneo D, Lamers I, Bertoni R, Feys P, Jonsdottir J. Participation restriction in people with multiple sclerosis: prevalence and correlations with cognitive, walking, balance, and upper limb impairments. Arch Phys Med Rehabil 2017; 98: 1308-1315.","DOI":"10.1016\/j.apmr.2017.02.015"},{"key":"72575","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1016\/j.apmr.2017.02.015","DOI":"10.1016\/j.apmr.2017.02.015"},{"key":"72576","doi-asserted-by":"crossref","unstructured":"Garg N, Smith TW. An update on immunopathogenesis, diagnosis, and treatment of multiple sclerosis. Brain Behav 2015; 5: e00362.","DOI":"10.1002\/brb3.362"},{"key":"72577","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1002\/brb3.362","DOI":"10.1002\/brb3.362"},{"key":"72578","doi-asserted-by":"crossref","unstructured":"Newsome SD, Thrower B, Hendin B, Danese S, Patterson J, Chinnapongse R. Symptom burden, management and treatment goals of people with MS spasticity: results from SEEN-MSS, a large-scale, self-reported survey. Mult Scler Relat Disord 2022; 68: 104376.","DOI":"10.1016\/j.msard.2022.104376"},{"key":"72579","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1016\/j.msard.2022.104376","DOI":"10.1016\/j.msard.2022.104376"},{"key":"72580","doi-asserted-by":"crossref","unstructured":"Safarpour Y, Mousavi T, Jabbari B. Botulinum toxin treatment in multiple sclerosis: a review. Curr Treat Options Neurol 2017; 19: 33.","DOI":"10.1007\/s11940-017-0470-5"},{"key":"72581","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1007\/s11940-017-0470-5","DOI":"10.1007\/s11940-017-0470-5"},{"key":"72582","doi-asserted-by":"crossref","unstructured":"Baricich A, Battaglia M, Cuneo D, Cosenza L, Millevolte M, Cosma M, et al. Clinical efficacy of botulinum toxin type A in patients with traumatic brain injury, spinal cord injury, or multiple sclerosis: an observational longitudinal study. Front Neurol 2023; 14: 1133390.","DOI":"10.3389\/fneur.2023.1133390"},{"key":"72583","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.3389\/fneur.2023.1133390","DOI":"10.3389\/fneur.2023.1133390"},{"key":"72584","doi-asserted-by":"crossref","unstructured":"Dressler D, Altavista MC, Altenmueller E, Bhidayasiri R, Bohlega S, Chana P, et al. Consensus guidelines for botulinum toxin therapy: general algorithms and dosing tables for dystonia and spasticity. J Neural Transm (Vienna) 2021; 128: 321-335.","DOI":"10.1007\/s00702-021-02312-4"},{"key":"72585","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1007\/s00702-021-02312-4","DOI":"10.1007\/s00702-021-02312-4"},{"key":"72586","doi-asserted-by":"crossref","unstructured":"Hefter H, Jost WH, Reissig A, Zakine B, Bakheit AM, Wissel J. Classification of posture in poststroke upper limb spasticity: a potential decision tool for botulinum toxin A treatment? Int J Rehabil Res 2012; 35: 227-233.","DOI":"10.1097\/MRR.0b013e328353e3d4"},{"key":"72587","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1097\/MRR.0b013e328353e3d4","DOI":"10.1097\/MRR.0b013e328353e3d4"},{"key":"72588","doi-asserted-by":"crossref","unstructured":"Picelli A, Vallies G, Chemello E, Castellazzi P, Brugnera A, Gandolfi M, et al. Is spasticity always the same? An observational study comparing the features of spastic equinus foot in patients with chronic stroke and multiple sclerosis. J Neurol Sci 2017; 380: 132-136.","DOI":"10.1016\/j.jns.2017.07.026"},{"key":"72589","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1016\/j.jns.2017.07.026","DOI":"10.1016\/j.jns.2017.07.026"},{"key":"72590","doi-asserted-by":"crossref","unstructured":"Kurtzke JF. Rating neurologic impairment in multiple sclerosis: an Expanded Disability Status Scale (EDSS). Neurology 1983; 33: 1444-1452.","DOI":"10.1212\/WNL.33.11.1444"},{"key":"72591","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1212\/WNL.33.11.1444","DOI":"10.1212\/WNL.33.11.1444"},{"key":"72592","doi-asserted-by":"crossref","unstructured":"Nuyens G, De Weerdt W, Ketelaer P, Feys H, De Wolf L, Hantson L, et al. Inter-rater reliability of the Ashworth scale in multiple sclerosis. Clin Rehabil 1994; 8: 286-292.","DOI":"10.1177\/026921559400800403"},{"key":"72593","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1177\/026921559400800403","DOI":"10.1177\/026921559400800403"},{"key":"72594","doi-asserted-by":"crossref","unstructured":"Lucchinetti C, Br\u00fcck W, Parisi J, Scheithauer B, Rodriguez M, Lassmann H. Heterogeneity of multiple sclerosis lesions: implications for the pathogenesis of demyelination. Ann Neurol 2000; 47: 707-717.","DOI":"10.1002\/1531-8249(200006)47:6<707::AID-ANA3>3.0.CO;2-Q"},{"key":"72595","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1002\/1531-8249(200006)47:6<707::AID-ANA3>3.0.CO;2-Q","DOI":"10.1002\/1531-8249(200006)47:6<707::AID-ANA3>3.0.CO;2-Q"},{"key":"72596","doi-asserted-by":"crossref","unstructured":"Kassam F, Lim B, Afroz S, Boissonnault \u00c8, Reebye R, Finlayson H, et al. Canadian physicians' use of intramuscular botulinum toxin injections for shoulder spasticity: a national cross-sectional survey. Toxins (Basel) 2023; 15: 58.","DOI":"10.3390\/toxins15010058"},{"key":"72597","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.3390\/toxins15010058","DOI":"10.3390\/toxins15010058"},{"key":"72598","doi-asserted-by":"crossref","unstructured":"Simpson DM, Patel AT, Alfaro A, Ayyoub Z, Charles D, Dashtipour K, et al. OnabotulinumtoxinA injection for poststroke upper-limb spasticity: guidance for early injectors from a Delphi panel process. PM R 2017; 9: 136-148.","DOI":"10.1016\/j.pmrj.2016.06.016"},{"key":"72599","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1016\/j.pmrj.2016.06.016","DOI":"10.1016\/j.pmrj.2016.06.016"},{"key":"72600","doi-asserted-by":"crossref","unstructured":"Tamburin S, Filippetti M, Mantovani E, Smania N, Picelli A. Spasticity following brain and spinal cord injury: assessment and treatment. Curr Opin Neurol 2022; 35: 728-740.","DOI":"10.1097\/WCO.0000000000001114"},{"key":"72601","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1097\/WCO.0000000000001114","DOI":"10.1097\/WCO.0000000000001114"},{"key":"72602","doi-asserted-by":"crossref","unstructured":"Moccia M, Annovazzi P, Buscarinu MC, Calabrese M, Cavalla P, Cordioli C, et al. Harmonization of real-world studies in multiple sclerosis: retrospective analysis from the rirems group. Mult Scler Relat Disord 2020; 45: 102394.","DOI":"10.1016\/j.msard.2020.102394"},{"key":"72603","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1016\/j.msard.2020.102394","DOI":"10.1016\/j.msard.2020.102394"},{"key":"72604","unstructured":"Gracies JM, Brashear A. Management of spasticity in stroke and multiple sclerosis. In: Dressler DB, Adib Saberi JC, Altenm\u00fcller E, editors. Botulinum toxin therapy. Berlin: Springer; 2012, p. 95-120."}],"container-title":["Journal of Rehabilitation Medicine"],"original-title":[],"link":[{"URL":"https:\/\/medicaljournalssweden.se\/jrm\/article\/download\/40548\/47000","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/medicaljournalssweden.se\/jrm\/article\/download\/40548\/47000","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,26]],"date-time":"2024-08-26T06:25:18Z","timestamp":1724653518000},"score":1,"resource":{"primary":{"URL":"https:\/\/medicaljournalssweden.se\/jrm\/article\/view\/40548"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,25]]},"references-count":35,"URL":"https:\/\/doi.org\/10.2340\/jrm.v56.40548","relation":{},"ISSN":["1651-2081"],"issn-type":[{"value":"1651-2081","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,8,25]]}}}