Quantitative measures of spasticity in post-stroke patients

Pisano, Fabrizio; Miscio, Giacinta; Conte, Carmen Del; Pianca, Danilo; Candeloro, Elisa; Colombo, Roberto

doi:10.1016/s1388-2457(00)00289-3

Cited by 146 publications

(131 citation statements)

References 32 publications

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“…66,67 The size of the responses appears to depend on a number of different factors including the level and type of physical activity of the individual, the age of the person and possibly also genetic factors. 66,68 Despite of this variability, most studies have found that the reflexes, when measured in resting individuals, are larger in a population of spastic individuals as compared to an age-matched population of healthy persons, 10,43,[69][70][71][72][73][74][75][76] see however Schindler-Ivens and Shields. 77 On the other hand, within the population of spastic individuals, usually no clear correlation is found between the size of the responses and the amount of spasticity as evaluated according to the MAS, 10,43,70,72 see however Allison and Abraham 78 and Sherwood et al 79 (Table 6).…”

Section: Electrophysiological Methodsmentioning

confidence: 99%

“…Some have evaluated the total resistance in the muscle at different stretch velocities while others have tried to differentiate the intrinsic and the velocitydependent torque components. The latter studies, for example, Pisano et al 43 have the advantage that they ignore morphological changes in the muscle due to inactivity or changes in neural control and thereby emphasize the hyper excitability and velocity-dependent increase in resistance/torque defined as spasticity. To evaluate spasticity, Firoozbakhsh et al 44 measured the total resistance to passive extension and flexion of the knee joint at 301, 601 and 1201/s (Table 5).…”

Section: Reliability Of Isokinetic Dynamometer Measurementsmentioning

confidence: 99%

“…Pisano et al 43 found stretch reflex threshold speed (determined from simultaneous electromyography (EMG) measurement) significantly lower in post-stroke individuals compared to controls. The stiffness indices were significantly higher in post-stroke individuals compared to controls (Table 5).…”

Section: Reliability Of Isokinetic Dynamometer Measurementsmentioning

confidence: 99%

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Spasticity-assessment: a review

2006

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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.

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Section: Electrophysiological Methodsmentioning

confidence: 99%

Section: Reliability Of Isokinetic Dynamometer Measurementsmentioning

confidence: 99%

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Spasticity-assessment: a review

2006

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“…Many of the limitations caused by stroke are related to spasticity. The condition is characterized by hyperexcitability of the velocity-dependent stretch reflex, exaggeration of deep tendon reflexes, increased muscle tonus and loss of movement control 3,4 . Among the many physiopathological mechanisms involved in spasticity, we highlight the effective loss of descending inhibitory influences, which increases excitability in gamma fusimotor neurons and alpha motor neurons 5,6 .…”

Section: Introductionmentioning

confidence: 99%

Immediate effects of TENS and cryotherapy in the reflex excitability and voluntary activity in hemiparetic subjects: a randomized crossover trial

Martins¹,

Carvalho²,

Silva³

et al. 2012

Rev. bras. fisioter.

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“…Many reports have evaluated the visco-elastic property of joints (1)- (7) . These studies have evaluated the resistant force (1) , the resonance frequency (2) , the dynamic stiffness transfer function (3) , the Nyquist diagram of stiffness (4) (5) , the EMG (6) and parameters related to stretch reflex (7) . All of them used the torque motor or kinematic equipment in order to apply sinusoidal oscillation or constant velocity extension to the joint.…”

Section: Introductionmentioning

confidence: 99%

Modeling the Step-like Response in the Upper Limbs of Hemiplegic Subjects for Evaluation of Spasticity

Uchiyama

Uchida

2005

IEEJ Trans.EIS

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The purpose of this study is to develop a new modeling technique for quantitative evaluation of spasticity in the upper limbs of hemiplegic patients. Each subject lay on a bed, and his forearm was supported with a jig to measure the elbow joint angle. The subject was instructed to relax and not to resist the step-like load which was applied to extend the elbow joint. The elbow joint angle and electromyogram (EMG) of the biceps muscle, triceps muscle and brachioradialis muscle were measured. First, the step-like response was approximated with a proposed mathematical model based on musculoskeletal and physiological characteristics by the least square method. The proposed model involved an elastic component depending on both muscle activities and elbow joint angle. The responses were approximated well with the proposed model. Next, the torque generated by the elastic component was estimated. The normalized elastic torque was approximated with a dumped sinusoid by the least square method. The reciprocal of the time constant and the natural frequency of the normalized elastic torque were calculated and they varied depending on the grades of the modified Ashworth scale of the subjects. It was suggested that the proposed modeling technique would provide a good quantitative index of spasticity as shown in the relationship between the reciprocal of the time constant and the natural frequency.

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Quantitative measures of spasticity in post-stroke patients

Cited by 146 publications

References 32 publications

Spasticity-assessment: a review

Spasticity-assessment: a review

Immediate effects of TENS and cryotherapy in the reflex excitability and voluntary activity in hemiparetic subjects: a randomized crossover trial

Modeling the Step-like Response in the Upper Limbs of Hemiplegic Subjects for Evaluation of Spasticity

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