Development of a new method for objective assessment of spasticity using full range passive movements.
OBJECTIVE
To develop a method for assessment of spasticity, in which the whole range of motion (ROM) at a wide variation of speeds is applied.


METHODS
Cross-sectional design to study construct validity.


METHODS
Research department affiliated with a rehabilitation hospital in The Netherlands.


METHODS
Nine patients with complete spinal cord injury recruited from the rehabilitation hospital.


METHODS
Not applicable.


METHODS
Thirty to 45 stretches over the whole ROM were applied to the triceps surae muscle at varying velocities measuring from 30 degrees to 150 degrees/s. Electromyographic responses were measured in order to assess reflex excitability. The torque over the ankle joint was measured during the whole stretch. The angle and velocity at which the reflex was initiated was also determined.


RESULTS
The electromyographic responses increased significantly at increasing stretch velocities (P<.001). The applied maximum angles are reproducible (intraclass correlation coefficient, .81) and provide representative torque responses.


CONCLUSIONS
The assessment method of spasticity using full range passive movements provides objective outcomes. The angular velocity is responsible for an exponential increase in amplitude of the electromyographic response.
van der Salm
Arjan
A
Roessingh Research & Development, Enschede, The Netherlands. a.vandersalm@rrd.nl
Veltink
Peter H
PH
Hermens
Hermie J
HJ
Ijzerman
Maarten J
MJ
Nene
Anand V
AV
D000328:Adult; D003430:Cross-Sectional Studies; D004576:Electromyography; D005260:Female; D006801:Humans; D035002:Lower Extremity / Q000503:physiopathology; D008297:Male; D009128:Muscle Spasticity / Q000503:physiopathology*; D016059:Range of Motion, Articular / Q000502:physiology*; D012026:Reflex, Stretch / Q000502:physiology; D015203:Reproducibility of Results; D013119:Spinal Cord Injuries / Q000503:physiopathology*; D019415:Torque