Influence of Posture and Muscle Length on Stretch Reflex Activity in Poststroke Patients With Spasticity

Fleuren, J.F.M.; Nederhand, Mark J.; Hermens, Hermie

doi:10.1016/j.apmr.2006.03.018

Cited by 38 publications

(28 citation statements)

References 38 publications

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“…Yet, long-lasting stimuli are of special interest as they occur in daily life (e.g., slippery or unstable surfaces and pushes). So far several attempts have been made to describe trigger characteristics in kinematic studies (e.g., pendulum test, isokinetic assessments) using movement as a trigger for reflexes [66, 67] or assessing muscle tone, spasticity, or rigidity [66–68]. However, until a precise time delimitation of the trigger can be established, movement onset seems to be the most plausible reference point for determining latencies following kinematic stimuli.…”

Section: Discussionmentioning

confidence: 99%

Evidence for Startle Effects due to Externally Induced Lower Limb Movements: Implications in Neurorehabilitation

Castellote

Kofler²,

Mayr³

et al. 2017

BioMed Research International

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Passive limb displacement is routinely used to assess muscle tone. If we attempt to quantify muscle stiffness using mechanical devices, it is important to know whether kinematic stimuli are able to trigger startle reactions. Whether kinematic stimuli are able to elicit a startle reflex and to accelerate prepared voluntary movements (StartReact effect) has not been studied extensively to date. Eleven healthy subjects were suspended in an exoskeleton and were exposed to passive left knee flexion (KF) at three intensities, occasionally replaced by fast right KF. Upon perceiving the movement subjects were asked to perform right wrist extension (WE), assessed by extensor carpi radialis (ECR) electromyographic activity. ECR latencies were shortest in fast trials. Startle responses were present in most fast trials, yet being significantly accelerated and larger with right versus left KF, since the former occurred less frequently and thus less expectedly. Startle responses were associated with earlier and larger ECR responses (StartReact effect), with the largest effect again upon right KF. The results provide evidence that kinematic stimuli are able to elicit both startle reflexes and a StartReact effect, which depend on stimulus intensity and anticipation, as well as on the subjects' preparedness to respond.

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Section: Discussionmentioning

confidence: 99%

Evidence for Startle Effects due to Externally Induced Lower Limb Movements: Implications in Neurorehabilitation

Castellote

Kofler²,

Mayr³

et al. 2017

BioMed Research International

View full text Add to dashboard Cite

show abstract

“…Generally somewhat higher levels of reliability were found in the upper extremity compared with the lower extremity,7 16 17 which could be due to the larger mass of the legs. Another factor that might affect reliability is lack of standardisation of the (M)AS 6 18 19. Possibly, factors such as the velocity and range of motion may affect the perceived resistance but these have never been quantified for this scale.…”

mentioning

confidence: 99%

Stop using the Ashworth Scale for the assessment of spasticity

Fleuren

Voerman

Erren-Wolters

et al. 2009

Journal of Neurology, Neurosurgery & Psychiatry

368

280

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“…In 6 articles the biomechanical and/or EMG were used to evaluate treatment of stroke patients [17,26,28,31,37,43], 10 articles addressed reliability or feasibility of the outcome measures in stroke patients [20,21,23,32,35,44,45,47-49] and 18 articles were observational (difference between healthy subjects and stroke patients) or tested a new measuring method [18,19,22,24,25,27,29,30,33,34,36,38-42,46,50]. A total of 682 stroke patients and 175 healthy subjects were included (see Additional file 1: Table S1).…”

Section: Resultsmentioning

confidence: 99%

The gap between clinical gaze and systematic assessment of movement disorders after stroke

Krogt

Meskers

Groot

et al. 2012

Journal of NeuroEngineering and Rehabilitation

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BackgroundMovement disorders after stroke are still captured by clinical gaze and translated to ordinal scores of low resolution. There is a clear need for objective quantification, with outcome measures related to pathophysiological background. Neural and non-neural contributors to joint behavior should be separated using different measurement conditions (tasks) and standardized input signals (force, position and velocity).MethodsWe reviewed recent literature for the application of biomechanical and/or elektromyographical (EMG) outcome measures under various measurement conditions in clinical research.ResultsSince 2005, 36 articles described the use of biomechanical and/or EMG outcome measures to quantify post-stroke movement disorder. Nineteen of the articles strived to separate neural and non-neural components. Only 6 of the articles measured biomechanical and EMG outcome measures simultaneously, while applying active and passive tasks and multiple velocities.ConclusionThe distinction between neural and non-neural components to separately assess paresis, stiffness and muscle overactivity is not commonplace yet, while a large gap is to be bridged to attain reproducible and comparable results. Pathophysiologically clear concepts, substantiated with a comprehensive and concise measuring protocol will help professionals to identify and treat limiting factors in movement capabilities of post-stroke patients.

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Influence of Posture and Muscle Length on Stretch Reflex Activity in Poststroke Patients With Spasticity

Cited by 38 publications

References 38 publications

Evidence for Startle Effects due to Externally Induced Lower Limb Movements: Implications in Neurorehabilitation

Evidence for Startle Effects due to Externally Induced Lower Limb Movements: Implications in Neurorehabilitation

Stop using the Ashworth Scale for the assessment of spasticity

The gap between clinical gaze and systematic assessment of movement disorders after stroke

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