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. 2020 Mar 4;15(1):64.
doi: 10.1186/s13023-020-1338-4.

Experienced complaints, activity limitations and loss of motor capacities in patients with pure hereditary spastic paraplegia: a web-based survey in the Netherlands

Bas J H van Lith  1 , Hans C J W Kerstens  2   3 , Laura A C van den Bemd  4 , Maria W G Nijhuis-van der Sanden  3 , Vivian Weerdesteyn  5 , Rob J E M Smeets  6 , Klemens Fheodoroff  7 , Bart P C van de Warrenburg  8 , Alexander C H Geurts  5
Affiliations

Experienced complaints, activity limitations and loss of motor capacities in patients with pure hereditary spastic paraplegia: a web-based survey in the Netherlands

Bas J H van Lith et al. Orphanet J Rare Dis. .

Abstract

Background: Hereditary spastic paraplegia (HSP) is a group of inherited disorders characterized by progressive spastic paresis of the lower limbs. Treatment is often focused on reducing spasticity and its physical consequences. To better address individual patients' needs, we investigated a broad range of experienced complaints, activity limitations, and loss of motor capacities in pure HSP. In addition, we aimed to identify patient characteristics that are associated with increased fall risk and/or reduced walking capacity.

Methods: We developed and distributed an HSP-specific online questionnaire in the Netherlands. A total of 109 out of 166 questionnaires returned by participants with pure HSP were analyzed.

Results: Participants experienced the greatest burden from muscle stiffness and limited standing and walking activities, while 72% reported leg and/or back pain. Thirty-five and 46% reported to use walking aids (e.g. crutches) indoors and outdoors, respectively; 57% reported a fall incidence of at least twice a year ('fallers'); in 51% a fall had led to an injury at least once; and 73% reported fear of falling. Duration of spasticity and incapacity to rise from the floor were positively associated with being a 'faller', whereas non-neurological comorbidity and wheelchair use were negatively associated. Higher age, experienced gait problems, not being able to stand for 10 min, and incapacity to open a heavy door showed a negative association with being a 'walker without aids' (> 500 m).

Conclusions: Our results emphasize the large impact of spastic paraparesis on the lives of people with pure HSP and contribute to a better understanding of possible targets for rehabilitation.

Keywords: Falls; Gait; Hereditary spastic paraplegia; Rehabilitation; Spastic paraparesis; Survey.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Median, interquartile range, and total range of the level of burden/hindrance that participants experienced in various categories (Questions B1-B13) (0: no burden/hindrance, 10: extreme burden/hindrance). +: outlier
Fig. 2
Fig. 2
Walking distance with and without aids
Fig. 3
Fig. 3
Percentage of participants that responded to be able to execute specific motor capacities with ease, with difficulty, or not at all
Fig. 4
Fig. 4
Self-reported fall frequency of participants
See this image and copyright information in PMC

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