Neurophysiological methods for the assessment of spasticity: The Hoffmann reflex, the tendon reflex, and the stretch reflex

Voerman, Gerlienke; Gregorič, M; Hermens, Hermanus J.

doi:10.1080/09638280400014600

Cited by 176 publications

(162 citation statements)

References 214 publications

Supporting

Mentioning

150

Contrasting

Unclassified

Order By: Relevance

“…15 Recently detailed reviews of clinical, biomechanical and neurophysiological methods for spasticity evaluation have been published. [16][17][18] In the present review, we evaluate some of the more common methods for assessment of spasticity, and our focus will be on individuals with SCL in particular. …”

Section: Assessmentmentioning

confidence: 99%

Spasticity-assessment: a review

2006

View full text Add to dashboard Cite

Study design: Review of the literature on the validity and reliability of assessment of spasticity and spasms. Objectives: Evaluate the most frequently used methods for assessment of spasticity and spasms, with particular focus on individuals with spinal cord lesions. Setting: Clinic for Spinal Cord Injuries, Rigshospitalet, University Hospital of Copenhagen, and Department of Medical Physiology, University of Copenhagen, Denmark. Methods: The assessment methods are grouped into clinical, biomechanical and electrophysiological, and the correlation between these is evaluated. Results: Clinical methods: For assessment of spasticity, the Ashworth and the modified Ashworth scales are commonly used. They provide a semiquantitative measure of the resistance to passive movement, but have limited interrater reliability. Guidelines for the testing procedures should be adhered to. Spasm frequency scales seem not to have been tested for reliability. Biomechanical methods such as isokinetic dynamometers are of value when an objective quantitative measure of the resistance to passive movement is necessary. They play a minor role in the daily clinical evaluation of spasticity. Electrophysiological methods: These techniques have provided valuable insight to the pathophysiological mechanisms involved in spasticity, but none of these techniques provide an easy and reliable assessment of spasticity for use in the daily clinic. Conclusion: A combination of electrophysiological and biomechanical techniques shows some promise for a full characterization of the spastic syndrome. There is a need of simple instruments, which provide a reliable quantitative measure with a low interrater variability.

show abstract

Section: Assessmentmentioning

confidence: 99%

Spasticity-assessment: a review

2006

View full text Add to dashboard Cite

show abstract

“…The accumulation of demyelinating plaques in the central nervous system involves cortical areas connected with maintenance of tone (such as premotor and motor areas; [5]) and different projections to spinal motoneurons, such as corticoreticulospinal fibers [6], with a consequent abnormal descending input. The pathological process is extended to spinal cord circuits, with a deregulation in segmental projections and interneuronal connections, such as reciprocal presynaptic, postsynaptic and recurrent inhibition [7]. The result is a modification of membrane properties of the alphamotoneuron and consequent changes in the threshold of activation, which eventually contribute to the genesis of abnormal muscle activity.…”

Section: Introductionmentioning

confidence: 99%

“…Conversely, clinical neurophysiology provide direct measures of the components of the neural stretch reflex; theoretically reflecting altered spinal mechanisms involved in the generation of motoneuronal hyperexcitability in spastic patients. Among them, short-latency stretch reflex measurements (such as H-reflex, F-wave, Stretch reflex and T-reflex studies) have been already investigated extensively by Voerman et al [7], showing a potential to contribute in the assessment of spasticity.…”

Section: Introductionmentioning

confidence: 99%

Neurophysiological Profile, Walking Performance Tests and Self-Reported Questionnaires in Spastic Patients with MS: A Pilot Study

Calvi¹,

Riz²,

Pietroboni³

2016

J Mult Scler

View full text Add to dashboard Cite

Nabiximols is currently being used as an add-on therapeutic option to treat severe forms of multiple sclerosis (MS) spasticity, especially in the progressive phase of the disease.The aim of this exploratory study is to evaluate the response to Nabiximols therapy and modifications in neurophysiological profile, improvement in walking performance tests and self-reported questionnaires, as possible further outcome measures of spasticity.

show abstract

“…6 Among the tendon reflexes of the lower limbs, PTR seems to be the reflex most steadily detected, whereas steady detection of Achilles tendon reflex (ATR) is difficult even in healthy persons. 7,8 Thus, although it was reported that a single clinical assessment of spasticity is a poor indication of a patient's general spasticity by Lechner et al 9 and PTR interpretation can sometimes be challenging, 10,11 we chose PTR as the simple, reproducible and relatively objective parameter. Accordingly, we conducted a retrospective survey of patients with cervical cord injury demonstrating complete sensorimotor paralysis to investigate the relationship of PTR appearing within 72 h after injury with recovery status from motor paralysis 6 months after injury.…”

Section: Introductionmentioning

confidence: 99%

Patellar tendon reflex as a predictor of improving motor paralysis in complete paralysis due to cervical cord injury

et al. 2009

View full text Add to dashboard Cite

Study design: A retrospective study. Objective: We have encountered several cases of complete sensorimotor paralysis in which patellar tendon reflex (PTR) was demonstrated approximately 3 days after injury and improvement of motor paralysis was subsequently achieved. We considered that PTR apparent in the early stage after injury may offer an index to predict improvements in motor paralysis. Materials and methods: A total of 142 patients assessed as ASIA Impairment Scale A on admission from 1979 to 1998 were included in the study. The patients who demonstrated PTR within 72 h after injury were classified as the PTR( þ ) group and those who did not constituted the PTR(À) group. With regard to the method of motor paralysis assessment at about 6 months after injury, patients assessed as ASIA Impairment Scale A or B (that is, complete motor paralysis) were classified as 'Non-recovered', whereas those assessed as ASIA Impairment Scale C, D or E (that is, showing obvious improvement of motor paralysis) were considered as 'Recovered'. Results: A significant difference was noted between groups, with the Recovered group including 16 of the 17 PTR( þ ) patients (94.1%) and 11 of the 115 PTR(À) patients (9.6%) (Po0.0001). Conclusion:The results obtained indicate that motor paralysis recovery could be expected at a very high rate among patients demonstrating PTR within 72 h of injury. As all physicians should be familiar with the PTR, this seems to represent a simple and highly useful sign to predict improvements in motor paralysis during the acute stage of cervical cord injury.

show abstract

Neurophysiological methods for the assessment of spasticity: The Hoffmann reflex, the tendon reflex, and the stretch reflex

Abstract: The clinical and experimental use of the three methods is restricted due to moderate reliability and sensitivity. It is recommended to perform combined neurophysiological-biomechanical assessment of spasticity during active, functional movement.

Cited by 176 publications

References 214 publications

Spasticity-assessment: a review

Spasticity-assessment: a review

Neurophysiological Profile, Walking Performance Tests and Self-Reported Questionnaires in Spastic Patients with MS: A Pilot Study

Patellar tendon reflex as a predictor of improving motor paralysis in complete paralysis due to cervical cord injury

Contact Info

Product

Resources

About