Functional outcome measures to assess interventions for spasticity

Hinderer, Steven R.; Gupta, Samir

doi:10.1016/s0003-9993(96)90073-8

Cited by 48 publications

(19 citation statements)

References 25 publications

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“…9 Others report a lack of improved function after local 5 or general 6 treatment of lower limb spasticity, whereas others report good results, 32 especially with neurotomy 8,9 or botulinum toxin A. [12][13][14] Hinderer and Gupta 33 emphasized that very few of the functional scales are operational for monitoring changes related to spasticity. Although patients were selected for the studies, the selection criteria were not given.…”

Section: Discussionmentioning

confidence: 99%

A Clinical Guide to Assess the Role of Lower Limb Extensor Overactivity in Hemiplegic Gait Disorders

Yelnik

Albert

Bonan

et al. 1999

Stroke

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Background and Purpose-The aim of this study was to assess the role of knee and ankle extensor overactivity in the hemiplegic gait observed in stroke victims and to propose a clinical guide for selecting patients before treatment of a supposed disabling spasticity. Methods-A standardized physical examination procedure was performed in 135 consecutive stroke patients. All patients were able to walk without human assistance. The period after stroke ranged from 3 to 24 months (mean, 11.5Ϯ7.25 months). Spasticity was evaluated with the stroke victim in sitting position and during walking. Overactivity of the quadriceps was considered disabling when inducing inability to flex the knee during the swing phase despite adequate control of knee flexion in sitting and standing positions; overactivity of the triceps surae was considered to be disabling when heel strike was not possible despite good control of the ankle flexion in sitting position; triceps retraction was also considered. Results-Disabling overactivity was observed in 56 (41.5%) patients: 11 times for the quadriceps femoris, 21 times for the triceps surae, and 21 times for both muscles. It was considered to be the main disorder impairing gait among only 16 (12%) patients: 9 for the quadriceps alone, 3 for the triceps alone, and 4 for both. Sitting spasticity of the lower limb was not predictive of disabling overactivity during walking. Conclusions-Extensor muscle overactivity is one of the components of gait disorders in stroke patients. The difficulty in assessing spasticity and its real causal effect in gait disturbances are discussed. A clinical guide is proposed. (Stroke. 1999;30:580-585.)

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Section: Discussionmentioning

confidence: 99%

A Clinical Guide to Assess the Role of Lower Limb Extensor Overactivity in Hemiplegic Gait Disorders

Yelnik

Albert

Bonan

et al. 1999

Stroke

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“…These studies also suggest that the Ashworth scale as a primary measure of spasticity in MS does not accurately assess the complex collection of symptoms associated with spasticity, which may be more accurately evaluated using subjective measures. Indeed, the use of the Ashworth scale as a primary measure of spasticity in MS has often being criticized, and many commonly used antispasticity medications have also failed to generate statistically significant improvements according to this scale (Hinderer and Gupta, 1996;Shakespeare et al, 2003). Accurate assessment of the clinical effectiveness of cannabinoids in MS may be complicated by the difficulty in achieving the most appropriate individual oral dose (Table 1).…”

Section: Central Nervous System Disordersmentioning

confidence: 99%

The Endocannabinoid System as an Emerging Target of Pharmacotherapy

2006

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“…Injury to the CNS that involves the cortico-reticulobulbo-spinal pathway results in altered muscle tone and reduced activity of the musculoskeletal system, which has repercussions for functional capacity 5,[13][14][15][16][17] . The leading cause of neurological dysfunction in the adult population is CVA 27 , which results in a number of incapacitating conditions.…”

Section: Discussionmentioning

confidence: 99%

“…Spasticity is defined as a velocity-dependent increase in the resistance of muscles to passive movement, as well as by muscle weakness, pronounced hyperreflexia, abnormal cutaneous and autonomic reflexes with the Babinski sign, caused by lesion of the upper motor neuron involving the cortico-reticulo-bulbo-spinal pathway 4,[7][8][9][10][11][12][13][14] . Since it affects the musculoskeletal system, the consequences of spasticity has a direct effect, albeit in varying degrees of severity, on the lives of patients, impairing their ability to carry out activities of daily living, as well as causing pain, contractions and deformities, all of which hinder the rehabilitation process [15][16][17][18][19] . Functional activity, or functionality, is defined as the ability to carry out activities of daily living such as feeding oneself, remaining mobile, making transfers, maintaining personal hygiene and locomoting 20 .…”

mentioning

confidence: 99%

Validation of the Santa Casa evaluation of spasticity scale

Pavan¹,

Marangoni²,

Shimizu³

et al. 2010

Arq. Neuro-Psiquiatr.

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Spasticity is a clinical condition that has negative repercussions on function. A scale capable of quantifying the severity and impact of an injury is fundamental to the rehabilitation process. The objective of this study was to retest and validate the Santa Casa evaluation of spasticity scale, a descriptive assessment of activities of daily living, transfers and locomotion. We analyzed spasticity and functional status in 97 hemiparetic patients. With statistical significance (p<0.05), this new scale demonstrated reliability in assessing clinical-functional conditions and reproducibility as a daily assessment scale for use during rehabilitation.

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Functional outcome measures to assess interventions for spasticity

Cited by 48 publications

References 25 publications

A Clinical Guide to Assess the Role of Lower Limb Extensor Overactivity in Hemiplegic Gait Disorders

A Clinical Guide to Assess the Role of Lower Limb Extensor Overactivity in Hemiplegic Gait Disorders

The Endocannabinoid System as an Emerging Target of Pharmacotherapy

Validation of the Santa Casa evaluation of spasticity scale

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