title: Examination of spasticity of the knee flexors and knee extensors using isokinetic dynamometry with electromyography and clinical scales in children with spinal cord injury.
abstract: OBJECTIVE
  To examine the role of reflex activity in spasticity and the relationship between peak passive torque, Ashworth Scale (AS), and Spasm Frequency Scale (SFS) of the knee flexors and extensors during the measurement of spasticity using an isokinetic dynamometer in children with spinal cord injury (SCI).
  
  
  METHODS
  Eighteen children with chronic SCI and 10 children of typical development (TD) participated. One set of 10 passive movements was completed using an isokinetic dynamometer at 15, 90, and 180 degrees per second (deg/s) while surface electromyographic data were collected from the vastus lateralis (VL) and medial hamstrings (MH). Spasticity was clinically assessed using the AS and SFS.
  
  
  RESULTS
  There were no significant differences in peak passive torque of the knee flexors and extensors at any velocity for children with SCI compared to children with TD. Children with TD demonstrated significantly more reflex activity of the MH during the assessment of knee flexor spasticity at all movement velocities than did children with SCI. Children with TD demonstrated significantly more reflex activity of the VL during the assessment of knee-extensor spasticity with movements at 180 deg/s. The relationship between peak passive torque, AS, and SFS was significant during movements at a velocity of 90 deg/s only.
  
  
  CONCLUSIONS
  The role of increased reflexes in spasticity needs further examination. Isokinetic dynamometry may be measuring a different aspect of spasticity than the AS and SFS do in children with SCI.
authors.affiliation: Shriners Hospitals for Children, Philadelphia, Pennsylvania, USA. srpierce@mail.widener.edu
authors.forename: Samuel R
authors.initials: SR
authors.lastname: Pierce
authors.forename: Therese E
authors.initials: TE
authors.lastname: Johnston
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Shewokis
authors.forename: Richard T
authors.initials: RT
authors.lastname: Lauer
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D004185:Disability Evaluation; D004576:Electromyography / Q000379:methods; D005260:Female; D006801:Humans; D007717:Knee / Q000503:physiopathology*; D008297:Male; D009119:Muscle Contraction; D009128:Muscle Spasticity / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology*; D053581:Muscle Strength Dynamometer; D018482:Muscle, Skeletal / Q000294:innervation / Q000503:physiopathology*; D009460:Neurologic Examination / Q000295:instrumentation / Q000379:methods; D010243:Paralysis / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D011237:Predictive Value of Tests; D016059:Range of Motion, Articular; D013119:Spinal Cord Injuries / Q000209:etiology / Q000503:physiopathology*; D019415:Torque