Lower extremity spasticity as an early marker of ambulatory recovery following traumatic brain injury.
METHODS
A consecutive series of 107 children and young persons with traumatic brain injury (TBI) admitted to a hospital-based inpatient rehabilitation program was assessed to determine whether lower extremity spasticity could be utilized as an early clinical marker for recovery of ambulation. Presence of spasticity was determined by clinical examination at admission, and the ability to ambulate safely indoors (15.24 m) was evaluated at discharge. Sensitivity, specificity and positive and negative predictive values for spasticity were calculated.


RESULTS
Lower extremity spasticity is a sensitive (71.4%) and specific (81.5%) predictor of the inability to ambulate at discharge. The absence of lower extremity spasticity, however, was a better predictor of ambulation recovery than the presence of spasticity was a predictor of nonambulatory status at hospital discharge.


CONCLUSIONS
Implications for spasticity assessment and prognosis in terms of ambulation and recovery are discussed.
Dumas
Helene M
HM
The Research Center for Children with Special Health Care Needs, Franciscan Children's Hospital and Rehabilitation Center, 30 Warren Street, Boston, MA 02135, USA. hdumas@fchrc.org
Haley
Stephen M
SM
Carey
Tara M
TM
Ludlow
Larry H
LH
Rabin
Jeffrey P
JP
D000293:Adolescent; D000328:Adult; D001930:Brain Injuries / Q000503:physiopathology / Q000534:rehabilitation*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007902:Length of Stay; D035002:Lower Extremity / Q000503:physiopathology*; D008297:Male; D009128:Muscle Spasticity / Q000503:physiopathology*; D009460:Neurologic Examination; D017063:Outcome Assessment, Health Care; D011237:Predictive Value of Tests; D020127:Recovery of Function; D012047:Rehabilitation Centers; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index