Clinical scales for the assessment of spasticity, associated phenomena, and function: a systematic review of the literature

Platz, Thomas; Eickhof, Christel; Nuyens, Godelieve; Vuadens, Philippe

doi:10.1080/09638280400014634

Cited by 214 publications

(153 citation statements)

References 98 publications

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“…The patients' evaluation of spasticity is often an ad hoc report and is rarely documented by using measurement tools like the spasm frequency scale or a visual analog scale (VAS). [11][12][13] Usually no differentiation is made between the perceived degree of spasticity and the experienced spasticity-related level of discomfort. Figure 1 shows a proposed basic model, showing the interrelationship between the different components of the ICF framework and the perception of the patient.…”

Section: Introductionmentioning

confidence: 99%

Perception of lower limb spasticity in patients with spinal cord injury

et al. 2008

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Study design: Cross-sectional study. Objective: To study the manifestation of spasticity in daily life of the patients with spinal cord injury, their perception of spasticity and spasticity-related discomfort. Setting: Rehabilitation center in the Netherlands. Methods: Twenty-six patients with motor complete spinal cord injury (SCI) and spasticity in the lower limbs completed a questionnaire. The following outcome measures were used: manifestation of spasticity, activities during which spasticity occurs, perceived degree of spasticity and resulting discomfort, measured with visual analog scale (VAS) and Borg scale, respectively. Results: In general, spasticity manifested as extensor spasms (84.6%), flexor spasms and/or clonus (both 69.2%), and less often as continuous tension (57.7%). The registered activities were categorized into five main groups: 'changing position' was the largest group (22.0%) with a median VAS of 6.8 (range: 2.5-9.5) and median Borg scale of 3.0 (range: 1.0-7.0). Other groups of activities were 'making a transfer' (20.7%), 'activities of daily living' (17.1%), 'being active' (17.1%) and 'stable body position' (12.2%). The overall correlation between VAS and Borg was moderate (Spearman's rho ¼ 0.53, P ¼ 0.005). Conclusions: Patients with complete SCI experienced several manifestations of spasticity, extensor spasms being the most common. Many daily life activities elicited different manifestations of spasticity. The experienced discomfort was only moderately related to the perceived degree of spasticity during an activity. Possibly, the discomfort is influenced by other factors than the perceived spasticity alone.

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Section: Introductionmentioning

confidence: 99%

Perception of lower limb spasticity in patients with spinal cord injury

et al. 2008

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“…NDT-Bobath for adult's method is one of the worldwide leading methods in post-stroke rehabilitation [8][9][10][11][12][13][14]. This method is not a set of exercises, but the whole concept containing clinical reasoning, movement analysis, analysis of level of disability, assessment of functional deficits and their causes.…”

Section: Introductionmentioning

confidence: 99%

Normalized gait parameters in NDT-Bobath post-stroke gait rehabilitation

Mikołajewska

2012

Open Medicine

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AbstractThe aim of the research was to evaluate the results of NDT-Bobath method in gait re-education of adult patients after ischemic stroke using normalized parameters of gait. The investigation group consisted of 60 patients, all sufferers of an ischemic stroke, and participated in a rehabilitation program: 10 sessions of NDT-Bobath therapy through 2 weeks (ten days of the therapy). Normalized parameters of gait were calculated based on anthropometric measures of patients and their gait parameters (gait velocity, cadence and stride length) measured in every patient on admission (before the therapy) and after the last session of the therapy to assess rehabilitation effects. Results among patients involved in the research were as follows: in normalized gait velocity: recovery in 42 cases (70 %), relapse in 10 cases (16,67 %), no measurable changes in 8 cases (13.33 %)in normalized cadence: recovery in 39 cases (65 %), relapse in 16 cases (26.67 %), no measurable changes in 5 cases (8.33 %)in normalized stride length: recovery in 50 cases (83.33 %), relapse in 4 cases (6.67 %), no measurable changes in 6 cases (10 %). Observed statistically significant and favourable changes in health status of patients, described by normalized gait parameters, confirm effectiveness of the NDT-Bobath method.

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“…Isso pode ter ocorrido, pois, segundo alguns pesquisadores, essa escala não é muito sensível às alterações pequenas de tensão muscular e, por isso, vem se tornando alvo constante de críticas 24 .…”

Section: Discussionunclassified

Técnica para redução do tônus e alongamento muscular passivo: efeitos na amplitude de movimento de crianças com paralisia cerebral espástica

Oliveira¹,

Golin²

2017

ABCS Health Sci.

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Introdução: A paralisia cerebral (PC) é resultante de lesão no encéfalo em fase de maturação, acarretando em disfunções motoras. A espasticidade, forma mais comum de acometimento, gera prejuízos funcionais intensificados pela diminuição da mobilidade. Objetivo: Analisar os efeitos do alongamento passivo lento do músculo tríceps sural e de técnica para diminuir o tônus do conceito Bobath na amplitude de movimento (ADM) de dorsiflexão do tornozelo de crianças com PC espástica. Métodos: Participaram 18 crianças atendidas no Hospital Estadual Mario Covas de Santo André e na Santa Casa de Diadema. O grau da hipertonia do músculo tríceps sural foi determinado pela Escala de Aswhorth Modificada e a ADM de dorsiflexão foi medida pela goniometria. Esses dois procedimentos foram realizados antes e após as seguintes situações: 1) aplicação de um protocolo de alongamento muscular passivo; 2) protocolo com uma técnica para diminuir o tônus do conceito Bobath; e 3) emprego associado dos dois protocolos. Resultados: O grau de hipertonia não se modificou após o protocolo 1, porém os protocolos 2 e 3 diminuíram a espasticidade de maneira semelhante, conforme a Escala de Ashworth Modificada. Já o ângulo de dorsiflexão aumentou após aplicação dos três protocolos: 1 (p=0,176); 2 (p=0,008); e 3, com o aumento mais significativo (p=0,003). Conclusão: A técnica para redução do tônus mostrou efeito positivo na redução da espasticidade, segundo a Escala de Ashworth Modificada, e no aumento da ADM de crianças espásticas. A execução subsequente do alongamento muscular aumentou sua efetividade.

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Clinical scales for the assessment of spasticity, associated phenomena, and function: a systematic review of the literature

Abstract: The collated evidence can guide our clinical decision about when to use which scale and can promote evidence-based assessment of spasticity and related clinical phenomena.

Cited by 214 publications

References 98 publications

Perception of lower limb spasticity in patients with spinal cord injury

Perception of lower limb spasticity in patients with spinal cord injury

Normalized gait parameters in NDT-Bobath post-stroke gait rehabilitation

Técnica para redução do tônus e alongamento muscular passivo: efeitos na amplitude de movimento de crianças com paralisia cerebral espástica

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