title: Spasticity, an impairment that is poorly defined and poorly measured.
abstract: OBJECTIVE
  To explore, following a literature review, whether there is a consistent definition and a unified assessment framework for the term 'spasticity'. The congruence between the definitions of spasticity and the corresponding methods of measurement were also explored.
  
  
  METHODS
  The search was performed on the electronic databases Web of Science, Science Direct and MEDLINE.
  
  
  METHODS
  A systematic literature search of publications written in English between the years 1980 and 2006 was performed with the following keywords: spasticity and tone. The search was limited to the following keywords: stroke, hemiplegia, upper, hand and arm.
  
  
  RESULTS
  Two hundred and fifty references contributed to this review (190 clinical trials, 46 literature reviews, and 14 case reports). Seventy-eight used the Lance definition; 88 equated spasticity with increased muscle tone; 78 provided no definition; and six others used their own definitions for spasticity. Most papers used a single measure and some used more than one. Forty-seven papers used neurophysiological methods of testing, 228 used biomechanical methods of measurement or assessment, 25 used miscellaneous clinical measures (e.g. spasm frequency scales) and 19 did not explicitly describe a measure.
  
  
  CONCLUSIONS
  The term spasticity is inconsistently defined and this inconsistency will need to be resolved. Often, the measures used did not correspond to the clinical features of spasticity that were defined within a paper (i.e. internal validity was compromised). There is need to ensure that this lack of congruence is addressed in future research.
authors.affiliation: School of Health & Rehabilitation and Research Institute for Life Course Studies, University of Keele, UK.
authors.forename: S
authors.initials: S
authors.lastname: Malhotra
authors.forename: A D
authors.initials: AD
authors.lastname: Pandyan
authors.forename: C R
authors.initials: CR
authors.lastname: Day
authors.forename: P W
authors.initials: PW
authors.lastname: Jones
authors.forename: H
authors.initials: H
authors.lastname: Hermens
mesh_terms: D002986:Clinical Trials as Topic; D016206:Databases, Bibliographic; D006429:Hemiplegia; D006801:Humans; D009128:Muscle Spasticity / Q000175:diagnosis / Q000503:physiopathology; D009129:Muscle Tonus; D012196:Review Literature as Topic; D020521:Stroke; D009626:Terminology as Topic