title: Measurement of Resistive Plantar Flexion Torque of the Ankle during Passive Stretch in Healthy Subjects and Patients with Poststroke Hemiplegia.
abstract: BACKGROUND
  Quantification of increased muscle tone for patients with spasticity has been performed to date using various devices to replace the manual scales, such as the modified Ashworth scale or the Tardieu scale. We developed a device that could measure resistive plantar flexion (PF) torque of the ankle during passive dorsiflexion (DF) as an indicator of muscle tone of ankle plantar flexors.
  
  
  METHODS
  The primary objective was to explore the test-retest intrarater reliability of a custom-built device. Participants were 11 healthy subjects (7 men, 4 women; mean age 47.0 years) and 22 patients with poststroke hemiplegia (11 hemorrhagic, 11 ischemic; 14 men, 8 women; mean age 57.2 years). The device was affixed to the ankle. Subjects were seated with knees either flexed or extended. The ankle was passively dorsiflexed from 20° of PF to more than 10° of DF at 5°/second (slow stretch) or 90°/second (fast stretch). Angle and torque were measured twice during the stretches. The intraclass correlation coefficients (ICCs) of torque at 10° of DF (T10) in the 4 conditions-slow and fast stretches with knee flexed or extended-were calculated.
  
  
  RESULTS
  The T10 ICCs of the 4 conditions were .95-.99 in both groups. The healthy subjects showed significantly higher T10 of knee extension than of knee flexion during slow and fast stretches. The patients showed increased velocity-dependent torque during fast stretches.
  
  
  CONCLUSIONS
  Excellent reliability was observed. The device is suitable for measuring resistive PF torque during passive stretch in a flexed knee condition.
authors: School of Medicine, Department of Rehabilitation Medicine II, Fujita Health University, Mie, Japan. Electronic address: shiho.mizuno@gmail.com.
authors: Shiho
authors: S
authors: Mizuno
authors: School of Medicine, Department of Rehabilitation Medicine II, Fujita Health University, Mie, Japan.
authors: Shigeru
authors: S
authors: Sonoda
authors: Fujita Memorial Nanakuri Institute, Fujita Health University, Mie, Japan.
authors: Kotaro
authors: K
authors: Takeda
authors: School of Medicine, Department of Rehabilitation Medicine II, Fujita Health University, Mie, Japan.
authors: Shinichiro
authors: S
authors: Maeshima
mesh_terms: D000328:Adult; D000368:Aged; D000843:Ankle Joint / Q000503:physiopathology*; D005260:Female; D006429:Hemiplegia / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000503:physiopathology*; D016059:Range of Motion, Articular / Q000502:physiology*; D012026:Reflex, Stretch / Q000502:physiology*; D015203:Reproducibility of Results; D020521:Stroke / Q000150:complications; D019415:Torque
keywords: Quantitative evaluation; increased muscle tone; spasticity; stroke