title: Correlation of Resting Elbow Angle with Spasticity in Chronic Stroke Survivors.
abstract: OBJECTIVE
  To evaluate whether resting joint angle is indicative of severity of spasticity of the elbow flexors in chronic stroke survivors.
  
  
  METHODS
  Seventeen hemiparetic stroke subjects (male: n = 13; female: n = 4; age: 37-89 years; 11 right and 6 left hemiplegia; averaged 54.8 months after stroke, ranging 12-107 months) participated in the study. The number of subjects with modified Ashworth scale score (MAS) = 0, 1, 1+, 2, and 3 was 3, 3, 5, 3, and 3, respectively. In a single experimental session, resting elbow joint angle, MAS, and Tardieu scale score (Tardieu R1) were measured. A customized motorized stretching device was used to stretch elbow flexors at 5, 50, and 100°/s, respectively. Biomechanical responses (peak reflex torque and reflex stiffness) of elbow flexors were quantified. Correlation analyses between clinical and biomechanical assessments were performed.
  
  
  RESULTS
  Resting elbow joint angle showed a strong positive correlation with Tardieu R1 (r = 0.77, p < 0.01) and a very strong negative correlation with MAS (r = -0.89, p < 0.01). The resting angle also had strong correlations with biomechanical measures (r = -0.63 to -0.76, p < 0.01).
  
  
  CONCLUSIONS
  Our study provides experimental evidence for anecdotal observation that the resting elbow joint angle correlates with severity of spasticity in chronic stroke. Resting angle observation for spasticity assessment can and will be an easy, yet a valid way of spasticity estimation in clinical settings, particularly for small muscles or muscles which are not easily measurable by common clinical methods.
authors.affiliation: Department of Physical Medicine and Rehabilitation, The University of Texas Health Science Center at Houston , Houston, TX , USA ; NeuroRehabilitation Research Laboratory, The NeuroRecovery Research Center at TIRR Memorial Hermann Research Center , Houston, TX , USA.
authors.forename: Minal Y
authors.initials: MY
authors.lastname: Bhadane
authors.affiliation: The University of Texas Southwestern Medical Center , Dallas, TX , USA.
authors.forename: Fan
authors.initials: F
authors.lastname: Gao
authors.affiliation: Department of Physical Medicine and Rehabilitation, The University of Texas Health Science Center at Houston , Houston, TX , USA ; NeuroRehabilitation Research Laboratory, The NeuroRecovery Research Center at TIRR Memorial Hermann Research Center , Houston, TX , USA.
authors.forename: Gerard E
authors.initials: GE
authors.lastname: Francisco
authors.affiliation: Department of Physical Medicine and Rehabilitation, The University of Texas Health Science Center at Houston , Houston, TX , USA ; NeuroRehabilitation Research Laboratory, The NeuroRecovery Research Center at TIRR Memorial Hermann Research Center , Houston, TX , USA ; Guangdong Work Injury Rehabilitation Center , Guangzhou , China.
authors.forename: Ping
authors.initials: P
authors.lastname: Zhou
authors.affiliation: Department of Physical Medicine and Rehabilitation, The University of Texas Health Science Center at Houston , Houston, TX , USA ; NeuroRehabilitation Research Laboratory, The NeuroRecovery Research Center at TIRR Memorial Hermann Research Center , Houston, TX , USA.
authors.forename: Sheng
authors.initials: S
authors.lastname: Li
keywords: MAS; Tardieu; resting angle; spasticity; stroke