Biomechanical investigation of the modified Tardieu Scale in assessing knee extensor spasticity poststroke

Abstract

Objective: The modified Tardieu Scale (MTS) is a clinical tool for the measurement of muscle spasticity. The present study aimed to investigate the relationship between the MTS and the slope of the work-velocity curve as a biomechanical measure in assessing knee extensor muscle spasticity in patients with stroke.Methods: Thirty patients with stroke (22 female, 8 male; mean age 55.4 ± 12.0 years) participated in this study. The knee extensor spasticity was assessed with the MTS. An isokinetic dynamometer was used to move the knee passively from full extension to 90°flexion at speeds of 60°/s, 120°/s, 180°/s, and 240°/s to collect torque-angle data. The slope of the work-velocity curve was calculated using linear regression [J/(°/s)].Results: The mean of R2-R1 component of MTS was 19.73 (SD 29.85). The mean work significantly decreased as the speed increased (p < .001). The mean (SD) slope for the work-velocity curve was −0.83 (SD 0.73, range −2.6-0.3). There was no significant relationship between the R 2 -R 1 and the slope of work-velocity curve (r = 0.09, p = .62). Conclusions:The lack of significant relationship between the MTS and the slope of workvelocity curve may question the usefulness of the MTS as a valid measure of muscle spasticity after stroke.

Spasticity Assessment in Cerebral Palsy

“…They showed low associations of the Ashworth Scale with these simultaneously assessed electrophysiological and biomechanical measurements (Fleuren et al 2010). Similarly, the MTS catch angle was found to have little association with increased work assessed at the joint (Gholami et al 2017). Also disconcerting is the finding that some subjects diagnosed as having spasticity by the clinical scales showed no signs of increased reflex activation as measured with EMG (Sinkjaer and Magnussen 1994; Galiana et al 2005).…”

Measuring muscle tone with isokinetic dynamometer technique in stroke patients

“…Slow velocity (5°/s) passive movement was used [10,22]. An interval of 30 s was allowed between sets of trials to avoid adaptation and minimize the influence of stretch history on the responses to subsequent stretches, and the time interval between each set of different velocities was 60 s [1,10]. The participants were instructed to remain relaxed and not to assist or resist the passive movement of their hand.…”

“…ID measures the amount of resistive torque generated by the muscle at different constant angular velocities [35]. Earlier studies that have tried to determine whether ID is appropriate for quantifying spasticity have mostly focused on patients with chronic stroke, and have reported spasticity to be speed dependent in elbow flexor and knee extensor muscles [4,10,35]. However, there is a lack of evidence regarding the measurement of spasticity with ID in patients with subacute stroke.…”