Assessment of spasticity using isokinetic dynamometry in patients with spinal cord injury

Akman, Mahmut Nafız; Bengi, R; Karataş, Metin; Kılınç, Şehri; Sözay, Seyhan; Özker, Rıdvan

doi:10.1038/sj.sc.3100892

Cited by 41 publications

(25 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…25,26 Following reports that SCS applied below the level of the lesion is less eective in cases involving severe spasticity, 10,11 we decided to explore the possibility of optimizing the approach by ®nding an appropriate site of stimulation. Encouraged by our previous ®nding of a central pattern generator (CPG) for locomotion in SCI patients, we hypothesized that there may exist a window for activating the lumbar spinal network at the level of the second dorsal lumbar roots.…”

Section: Discussionmentioning

confidence: 99%

Epidural electrical stimulation of posterior structures of the human lumbosacral cord: 3. Control of spasticity

Pinter¹,

2000

View full text Add to dashboard Cite

Objectives: The purpose of this study was to evaluate the eect of spinal cord stimulation (SCS) on severe spasticity of the lower limbs in patients with traumatic spinal cord injury (SCI) under close scrutiny of the site and parameters of stimulation. Materials and methods: Eight SCI patients (four women, four men) were included in the study. Levels of spasticity before and during stimulation were compared according to a clinical rating scale and by surface electrode polyelectromyography (pEMG) during passive¯exion and extension of the knee, supplemented by a pendulum test with the stimulating device switched either on or o over an appropriate period. Results: Both the clinical and the experimental parameters clearly demonstrated that SCS, when correctly handled, is a highly eective approach to controlling spasticity in spinal cord injury subjects. The success of this type of treatment hinges on four factors: (1) the epidural electrode must be located over the upper lumbar cord segment (L1, L2, L3); (2) the train frequency of stimulation must be in the range of 50 ± 100 Hz, the amplitude within 2 ± 7 V and the stimulus width of 210 ms; (3) the stimulus parameters must be optimized by clinically assessing the eect of arbitrary combinations of the four contacts of the quadripolar electrode; and (4) amplitudes of stimulation must be adjusted to dierent body positions. Conclusions: Severe muscle hypertonia aecting the lower extremities of patients with chronic spinal cord injuries can be eectively suppressed via stimulation of the upper lumbar cord segment. Spinal Cord (2000) 38, 524 ± 531

show abstract

Section: Discussionmentioning

confidence: 99%

Epidural electrical stimulation of posterior structures of the human lumbosacral cord: 3. Control of spasticity

Pinter¹,

2000

View full text Add to dashboard Cite

show abstract

“…[11][12][13] With this technique, it is possible to test the resistance to passive movement in the joints with preset speeds at different lengths of the same muscle. As one of the definitions of spasticity is a velocity-dependent increase in muscle tone to passive stretching, 14 isokinetic dynamometry seems to be a suitable technique suited for this purpose.…”

Section: Introductionmentioning

confidence: 99%

The effect of passive cycling movements on spasticity after spinal cord injury: preliminary results

Kakebeeke

Lechner

Knapp³

2005

Spinal Cord

View full text Add to dashboard Cite

Objective: To investigate the influence of rhythmic passive movements of the legs on the reduction of spasticity after spinal cord injury (SCI). Setting: Swiss Paraplegic Centre Nottwil, Switzerland. Methods: A total of 10 subjects with motor complete SCI were treated with a cycling device for half an hour. Before and after cycling their spasticity was tested with an isokinetic dynamometer. The subjects were tested one week later by exactly the same procedure with a half an hour break instead of the cycling. Subjects were asked about their spasticity before and after the cycling and break. Results: There was no significant difference in elicited peak torque either before and after the cycling, or before and after the break (MANOVA, Po0.05). Six out of 10 subjects estimated their spasticity as less after the cycling. Conclusion: With the isokinetic dynamometer, it was not possible to show an effect of passive cycling on spasticity reduction. However, six out of 10 of the subjects estimated their spasticity to be less after cycling. This positive effect might be attributed to a reduced spasticity in the trunk and/or to the attention the subjects perceived during the intervention.Spinal Cord (2005) 43, 483-488.

show abstract

“…In addition, work was not significantly correlated with injury duration, which is consistent with a prior study asserting that work is not a spasticity indicator. 45 Furthermore, the decreased peak torque and SI FOP over time suggest that plantar-flexor elasticity decreases with injury duration. However, several studies have found that the plantar-flexor passive-elasticity in the chronic SCI patients was higher than observed in the healthy age-matched participants.…”

Section: Discussionmentioning

confidence: 99%

Mechanical and neural changes in plantar-flexor muscles after spinal cord injury in humans

et al. 2015

View full text Add to dashboard Cite

Study design: Cross-sectional study. Objectives: To determine the effect of injury duration on plantar-flexor elastic properties in individuals with chronic spinal cord injury (SCI) and spasticity. Setting: National Rehabilitation Center for Persons with Disabilities, Japan. Methods: A total of 16 chronic SCI patients (age, 33 ± 9.3 years; injury localization, C6-T12; injury duration, 11-371 months) participated. Spasticity of the ankle plantar-flexors was assessed using the Modified Ashworth Scale (MAS). The calf circumference and muscle thickness of the medial gastrocnemius (MG), lateral gastrocnemius and soleus were assessed using tape measure and ultrasonography. In addition, the ankle was rotated from 10°plantar-flexion to 20°dorsiflexion at 5 deg s −1 with a dynamometer, and the ankle angle and torque were recorded. After normalizing the data (the initial points of angle and torque were set to zero), we calculated the peak torque and energy. Furthermore, angle-torque data (before and after normalization) were fitted with a second-and fourth-order polynomial, and exponential (Sten-Knudsen) models, and stiffness indices (SI SOP, SI FOP, SI SK ) and Angle SLACK (the angle at which plantar-flexor passive torque equals zero) were calculated. The stretch reflex gain and offset were determined from 0-10°d orsiflexion at 50, 90, 120 and 150 deg s −1 . After logarithmic transformation, Pearson's correlation coefficients were calculated. Results: MAS, calf circumference, MG thickness, peak torque and SI FOP significantly decreased with injury duration (r loglog = − 0.63, − 0.69, − 0.63, − 0.53 and − 0.55, respectively, Po0.05). The peak torque and SI FOP maintained significant relationships even after excluding impacts from muscle morphology. Conclusion: Plantar-flexor elasticity in chronic SCI patients decreased with increased injury duration.

show abstract

Assessment of spasticity using isokinetic dynamometry in patients with spinal cord injury

Cited by 41 publications

References 13 publications

Epidural electrical stimulation of posterior structures of the human lumbosacral cord: 3. Control of spasticity

Epidural electrical stimulation of posterior structures of the human lumbosacral cord: 3. Control of spasticity

The effect of passive cycling movements on spasticity after spinal cord injury: preliminary results

Mechanical and neural changes in plantar-flexor muscles after spinal cord injury in humans

Contact Info

Product

Resources

About