Altered motor control and spasticity after spinal cord injury: subjective and objective assessment.
This study of measures of spasticity, or altered motor control, compares the clinically used Ashworth scale with a method based on surface electromyographic (sEMG) recordings called brain motor control assessment (BMCA) in a group of 97 subjects with spinal cord injury (SCI) and varying levels of motor dysfunction. In this paper, we describe how sEMG-derived scores relate to the severity of spasticity as judged clinically. When sEMG data from passive movements from the BMCA were analyzed by Ashworth category, we found that when the sEMG data were averaged for a limb, there was a significant difference between scores for those with Ashworth 0 vs. 2 and 3, and 1 vs. 2 and 3 (p<0.001), but not between 0 and 1. Analysis of the individual muscle scores improved the discrimination between Ashworth categories. Superiority of sEMG data over Ashworth category as an objective quantification of altered motor control ("spasticity") is argued.
Sherwood
A M
AM
Rehabilitation Research and Development Center of Excellence on Healthy Aging with Disabilities, Department of Veterans Affairs Medical Center, Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Housto.
Graves
D E
DE
Priebe
M M
MM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D002574:Cervical Vertebrae; D004576:Electromyography / Q000379:methods*; D005260:Female; D006621:Hip Joint / Q000503:physiopathology; D006801:Humans; D015601:Injury Severity Score; D007719:Knee Joint / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D019957:Motor Skills Disorders / Q000175:diagnosis* / Q000209:etiology; D009128:Muscle Spasticity / Q000175:diagnosis* / Q000209:etiology; D010808:Physical Examination / Q000379:methods; D016059:Range of Motion, Articular; D015203:Reproducibility of Results; D012494:Sampling Studies; D012680:Sensitivity and Specificity; D013119:Spinal Cord Injuries / Q000150:complications*; D013904:Thoracic Vertebrae