Assessment and Measurement of Spasticity in MS: State of the Evidence

  • Cinda L. HugosEmail author
  • Michelle H. Cameron
Demyelinating Disorders (J. Bernard & M. Cameron, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Demyelinating Disorders


Purpose of Review

The purpose of this review is to familiarize the reader with assessments and measurement of spasticity in people with multiple sclerosis (MS). Spasticity affects 60–84% of people with MS, worsening as disability worsens and impacting activity, participation, and quality of life. Spasticity manifests in many ways, including spasms, resistance to passive stretch, pain, and perception of tightness, and can affect muscles throughout the body, making assessment and quantification of spasticity challenging but important. Assessment tools include those quantified by clinicians, instrumentation, and patients.

Recent Findings

Most tools for measuring spasticity are based on clinician scoring, were developed many years ago, and have undergone minimal recent advances. More recent developments are patient-reported outcome measures for spasticity, including the Numeric Rating Scale for Spasticity (NRS-S) and the disease-specific Multiple Sclerosis Spasticity Scale-88 (MSSS), and, most recently, imaging through elastography.


MS-related spasticity is common and often disabling. There are various spasticity measurement tools available, each with advantages and limitations. Newer tools are likely to be developed as our understanding of spasticity in MS grows.


Multiple sclerosis Spasticity Measurement Assessment Outcomes 


Compliance with Ethical Standards

Conflict of Interest

Cinda L. Hugos declares no potential conflicts of interest. Michelle H. Cameron reports consulting fees from Adamas Pharmaceuticals and Greenwich Bioscience/GW Pharmaceuticals, outside the submitted work.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


The contents do not represent the views of the U.S. Department of Veterans Affairs or the United States Government.


Papers of particular interest, published recently, have been highlighted as: • Of importance

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Copyright information

© This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply 2019

Authors and Affiliations

  1. 1.Department of NeurologyOregon Health & Science UniversityPortlandUSA
  2. 2.VA Portland Health Care SystemPortlandUSA
  3. 3.VA MS Center of Excellence-WestVA Portland Health Care SystemPortlandUSA

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