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Epidemiological, humanistic, and economic burden of illness of lower limb spasticity in adults: a systematic review

Authors Martin A, Abogunrin S, Kurth H, Dinet J

Received 3 September 2013

Accepted for publication 25 November 2013

Published 23 January 2014 Volume 2014:10 Pages 111—122

DOI https://doi.org/10.2147/NDT.S53913

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Alison Martin,1 Seye Abogunrin,1 Hannah Kurth,2 Jerome Dinet2

1Evidera, London, UK; 2Ipsen, Boulogne Billancourt Cedex, France

Background: The purpose of this study was to investigate the epidemiological, humanistic, and economic burden of illness associated with adult lower limb spasticity (LLS) and its complications.
Methods: A systematic search of MEDLINE and EMBASE identified 23 studies published between January 2002 and October 2012 that assessed the epidemiology, impact, and resource use associated with LLS. A hand-search of four neurology conferences identified abstracts published between 2010 and 2012.
Results: LLS was found to occur in one third of adults after stroke, half to two thirds with multiple sclerosis, and three quarters with cerebral palsy. LLS limits mobility and reduces quality of life. No clear association was found between LLS and occurrence of pain, development of contractures, or risk of falls.
Conclusion: The evidence on the burden of LLS and its complications is surprisingly limited given the condition's high prevalence among adults with common disorders, such as stroke. Further research is needed to clarify the impact of LLS, including the likelihood of thrombosis in spastic lower limbs. The dearth of high-quality evidence for LLS suggests a lack of awareness of, and interest in, the problem, and therefore, the unmet need among patients and their carers.

Keywords: muscle spasticity, cost of illness, complications, quality of life


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