Balance and Spasticity: What We Know and What We Believe

In September 1992, the Executive Committee of the Consortium of Multiple Sclerosis Centers selected members for the physical therapy specialty panel. The group's responsibility was to review current literature and clinical practice on spasticity and balance in multiple sclerosis care. This task was achieved through individual work and conference calls and the results were reported at the multidisciplinary “What Do We Know About MS?” conference in June 1993. With input from forty other health care professionals experienced with MS care, two research questions were generated by the physical therapy panel. The question for balance was “Which of the three clinical measurement tools—Tinetti, Berg, or Functional Reach—is the best predictor of falls in the MS client, and how do they correlate with an experienced clinician's subjective evaluation?” The question for spasticity was “Will a daily stretching program result in decreased spasticity severity and improved functional mobility in ambulatory MS clients?” The findings from the spasticity question will provide a scientific basis for a common clinical practice in MS. The findings from the balance question will validate reliable clinical tools that may assess risk for falling in MS clients. The experience and findings were shared at the annual Consortium meeting in Victoria in September 1993.