Tardue scales in the diagnostic of spasticity

Коваленко, А. П.; Мисиков, В К; Iskra, D A; Koshkarev, M A; Sinelnikov, Konstantin

doi:10.17116/jnevro201911909183

Cited by 8 publications

(8 citation statements)

References 15 publications

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“…While a professional consensus has been formed on the upper limb spasticity patterns based on the work of H. Hefter, a consolidated opinion on the lower limb spasticity patterns has not been developed, and the question of determining target muscles and BoNT dosages still remains open [11].…”

Section: Lower Limb Muscle Testingmentioning

confidence: 99%

“…The measurement system incorporated in MTS is performed by a goniometer and must be performed at the same time of the day, and the tested limb must be placed in the same position during repeated testing (Figure 17) [11].…”

Section: Scales For Assessing Spasticity and Disorders Of Activity Anmentioning

confidence: 99%

“…In this case, the measurement system is different from that adopted in orthopedic practice. The reference point is the point is opposite to the studied movement or, in other words, the measurement is carried out from the extreme points of flexion/extension, reduction/withdrawal, pronation/supination, that is, the points to which the cocontraction tends [11]. The point is selected along the axis of the limb segment under study, regardless of whether the segment reaches this point or not.…”

Section: Scales For Assessing Spasticity and Disorders Of Activity Anmentioning

confidence: 99%

“…Most often, spasticity limits the following movements: flexion and retraction in the shoulder joint, extension in the elbow, wrist and wrist joints, supination of the forearm, extension/flexion of the hip and knee joints, hip abduction, extension and pronation of the foot, and extension of the toes [19,35]. Accordingly, the reference point for measuring the volume of these movements will be located at the point of maximum contraction of the muscles that prevent this movement (Figures 19-25) [11]. Considering the treatment of spasticity as part of the rehabilitation process and, given that the therapeutic effect on spasticity has the ultimate goal of normalizing the life and activities of the patient, Graces recommends the following step-by-step strategy for the use of the tardier scale [33].…”

Section: Scales For Assessing Spasticity and Disorders Of Activity Anmentioning

confidence: 99%

“…The process of spasticity development is quite dynamic and variable. The terms of spasticity development from the first signs of tonus increase to the formed pattern in 2-5 weeks [9][10][11].…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Spasticity: Diagnosis and Treatment

Коваленко¹,

Мисиков²,

Sinelnikov³

et al. 2020

Neurostimulation and Neuromodulation in Contemporary Therapeutic Practice

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This chapter presents the technology of spasticity treatment-from diagnosis and treatment to quality control of treatment and rehabilitation. The diagnosis is based on methods of manual testing and differential diagnosis of spastic muscles, methods of quantitative assessment of spasticity on the basis of the Tardieu scale. The methodical development of the Tardieu scale with variants of its full and reduced use is presented. The basic patterns of spasticity of the upper and lower limbs are given. Schemes of management of patients with spasticity with indication of control points for application of methods of an assessment that shows efficiency of treatment and rehabilitation are presented. The methodology of spasticity treatment using botulinum neurotoxin (BoNT), including ultrasonic navigation, orientation of intramuscular motor endpoint of muscles (IME), is described. IME location diagrams and ultrasound picture of muscles are presented. Scales are proposed to assess the effect of spasticity on the functions of the upper and lower limbs. In conclusion, a variant of complex treatment of spasticity and original patient models are proposed, the use of which makes it possible to calculate the cost of BoNT.

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Section: Lower Limb Muscle Testingmentioning

confidence: 99%

Section: Scales For Assessing Spasticity and Disorders Of Activity Anmentioning

confidence: 99%

Section: Scales For Assessing Spasticity and Disorders Of Activity Anmentioning

confidence: 99%

Section: Scales For Assessing Spasticity and Disorders Of Activity Anmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Spasticity: Diagnosis and Treatment

Коваленко¹,

Мисиков²,

Sinelnikov³

et al. 2020

Neurostimulation and Neuromodulation in Contemporary Therapeutic Practice

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Gait rehabilitation in patients with spastic hemiparesis: new opportunities

Коваленко

Rodionov

Kremlyov

et al. 2021

RJTAO

Self Cite

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Spasticity syndrome in cerebral pathology: evaluation and clinical models

Коваленко

Voznyuk

Мисиков

2021

RJTAO

Self Cite

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Knowing the frequency of spasticity patterns in different muscles allows correcting the botulinum neurotoxin (BoNT) administration schemes and creating spasticity models that could predict the drug consumption and treatment cost.Objective: to develop clinical spasticity models based on the frequencies of the spastic syndrome in the muscles of the extremities in post-stroke patients to optimize BoNT administration.Patients and methods. We examined 129 patients of both sexes aged 61.2±8.0 years with post-stroke spasticity (mean time after the stroke – 4.6±2.2). Twenty-seven muscles were tested for spasticity: shoulder girdle (n=3), upper (n=9) and lower (n=15) extremities. We used the original manual testing methods (MTM) of spasticity and the Tardieu scale (TS).Results and discussion. We observed the following frequencies of spasticity in the arm muscles: pectoralis major, brachioradialis, pronator teres, fl. carpi radialis, fl. digitorum profundus et superfacialis, fl. pollicis long. – over 70%, subscapularis – 61%, brachialis – 56.6%, biceps brachii – 35.8%. Frequencies of spasticity in the leg muscles were: semitendinosus, semimembranosus, fl. digitorum long. – 37.5%, gracilis – 21.4%, cap. med. gastrocnemius – 48%, tibialis post. – 39.2%, soleus – 19.6%, fl. halluces long. – 23%. There was no spasticity in the hip adductors; low spasticity incidence was seen in fl. digitorum brev. et fl. halluces brev. (<10%), tibialis ant., rectus femoris (<5%); biceps femoris, teres major, fl. carpi ulnaris, and cap. lat. gastrocnemius (<2%). Based on the frequency of identified spastic patterns, we created four models of patients with arm spasticity and five models – with leg spasticity with the calculation of the necessary doses of BoNT.Conclusion. We propose several spasticity models, which allow calculating the treatment costs, considering the frequency of involvement of specific muscles in spasticity evaluation, and tracking the rehabilitation follow-up of the patient's transition from one clinical model to another.

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Tardue scales in the diagnostic of spasticity

Cited by 8 publications

References 15 publications

Spasticity: Diagnosis and Treatment

Spasticity: Diagnosis and Treatment

Gait rehabilitation in patients with spastic hemiparesis: new opportunities

Spasticity syndrome in cerebral pathology: evaluation and clinical models

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