ABSTRACT
@#Background & Objectives: Muscle cramps are present in more than three quarter of amyotrophic lateral sclerosis (ALS) cases. The objective of the present study was to translate and validate Columbia Cramp Scale (CCS) for use in Serbian ALS patients, and to identify the potential epidemiological and clinical factors which could influence worse overall CCS score. Methods: This study involved 21 patients with muscle cramps and 17 patients with no previous cramps history. Patients with cramps were retested 3 months after first assessment. Main socio-demographic and clinical data were obtained from patients at time of testing. The revised ALS functional rating scale (ALS-FRS-R) was used to score activities of daily living. The study subjects were assessed with CCS, Hamilton scales for the assessment of anxiety (HAM-A) and depression (HAM-D) and 36-Item Short Form Survey (SF-36). Results: Mean CCS score was 17.2±6.7 (range 6-30). The Cronbach’s alpha coefficient reflecting internal consistency was 0.76, which suggest acceptable internal consistency. Multiple linear regression analysis including all parameters associated with worse CCS scores, showed that lower ALSFRS-R scores (beta=0.55, p<0.01) and depression (beta=0.52, p<0.01), were independent predictors of the worse CCS score (adjusted R2=0.35, p<0.01 for overall model). Subjects with cramp history were retested after 3 months and no statistically significant difference between CCS scores in this two time points was noted. Conclusion: Selection of appropriate measure for assessing muscle cramps is important. In ALS patients we recommend CCS questionnaire. Results of our study also show that high CCS scores correlate with depression and anxiety, worse QoL and some epidemiological and clinical characteristics.
