Quantitative clinical measure of spasticity in children with cerebral palsy.
OBJECTIVE
This investigation developed an objective measure to quantify the degree of spasticity.


METHODS
Specifications included a single variable that integrated key elements characterizing spasticity: velocity, range of motion, and resistance to passive motion. A dynamometer at a children's hospital quantified the passive resistance of the hamstrings to knee extension for a range of motion at 4 different speeds for the prospective descriptive investigation.


METHODS
A convenience sample of six children with able bodies and 17 children with spastic diplegic cerebral palsy volunteered. DATA PROCESSING: Torque-angle data were processed to calculate the work done by the machine on the children for each speed and then determine the slope of the work-velocity curves. This slope was considered to be the measure of spasticity and it was hypothesized that children with cerebral palsy would have a greater slope than children with able bodies. An independent test determined whether a significant difference existed between groups (p < .05).


RESULTS
Torque-angle data for children with able bodies indicated little change in passive resistance as a function of speed. Similar data for children with cerebral palsy indicated larger resistive torques with increasing speed. Slope from the work-velocity data was close to zero for children with able bodies [.003 J/(degrees/sec)], while the corresponding slope for children with cerebral palsy was approximately 10 times greater [.031 J/(degrees/sec)] and significantly different (p < .05).


CONCLUSIONS
The slope of the work-velocity data integrates three major components characterizing spasticity, it is a single number that can easily be evaluated and interpreted in a clinical setting, and it utilizes a machine that is available at many centers.
Engsberg
J R
JR
Department of Neurosurgery, St. Louis Children's Hospital, MO 63110, USA.
Olree
K S
KS
Ross
S A
SA
Park
T S
TS
D000293:Adolescent; D002547:Cerebral Palsy / Q000503:physiopathology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000502:physiology; D008297:Male; D009119:Muscle Contraction; D009128:Muscle Spasticity / Q000145:classification* / Q000503:physiopathology; D011446:Prospective Studies; D016059:Range of Motion, Articular; D012494:Sampling Studies