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The construct validity of a spasticity measurement device for clinical practice: An alternative to the Ashworth scales

Lookup NU author(s): Dr Anand Pandyan, Frederike Van Wijck, Professor Garth Johnson, Professor Michael Barnes

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Abstract

Introduction. Spasticity is a significant cause of disability in people with an upper motor neurone lesion, but there is a paucity of appropriate outcome measures to evaluate this phenomenon. The aim was to test the construct validity of a clinically relevant, non-invasive measure of spasticity. Methods. A cross-section study design in which participants with elbow flexor spasticity and capable of providing written informed consent were recruited. Results. Fourteen stroke patients participated (six female and eight male). Median age was 61 years and the median time post stroke was 48 months. Six patients had a MAS grading of '1+' three a grade of '2'and five a grade of '3'. The velocity of the brisk stretch was significantly higher than that of the slow stretch (p < 0.05: median difference, 2.0μV; IQR, 0.04-8.4). In contast the RPE was not significantly different between the slow and the fast strecthes (p > 0.1: median difference, 0107 N/deg; IQR, -0.09-0.16). There were no patterns of association between the MAS, elbow flexor muscle activity and RPE. Other important observations, in some patients, were: Continuous background muscle activation consistent with descriptions of spastic dystonia; muscle activity at the slow velocity stretch; muscle activation patterns consistent with the clasp-knife phenomenon. Conclusions. The measurement system was capable of measuring spasticity as defined by Lance (1980; In: Lance et al., editors. Spasticity: Disordered motor control. Chicago, IL: Year Book. p 185 - 204). In addition, it enabled various other clinical phenomena associated with spasticity to be measured. Assessing spasticity by measuring changes in resistance to passive movement only may not be sufficient, as the latter is influenced by many factors of which spasticity may only be one. Further work is now required to investigate repeatability and sensitivity. © 2006 Taylor & Francis.


Publication metadata

Author(s): Pandyan AD, Van Wijck FMJ, Stark S, Vuadens P, Johnson GR, Barnes MP

Publication type: Article

Publication status: Published

Journal: Disability and Rehabilitation

Year: 2006

Volume: 28

Issue: 9

Pages: 579-585

ISSN (print): 0963-8288

ISSN (electronic): 1464-5165

Publisher: Informa Healthcare

URL: http://dx.doi.org/10.1080/09638280500242390

DOI: 10.1080/09638280500242390

PubMed id: 16690587


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