title: Normative NeuroFlexor data for detection of spasticity after stroke: a cross-sectional study.
abstract: OBJECTIVE
  The NeuroFlexor is a novel instrument for quantification of neural, viscous and elastic components of passive movement resistance. The aim of this study was to provide normative data and cut-off values from healthy subjects and to use these to explore signs of spasticity at the wrist and fingers in patients recovering from stroke.
  
  
  METHODS
  107 healthy subjects (age range 28-68 years; 51 % females) and 39 stroke patients (age range 33-69 years; 33 % females), 2-4 weeks after stroke, were assessed with the NeuroFlexor. Cut-off values based on mean + 3SD of the reference data were calculated. In patients, the modified Ashworth scale (MAS) was also applied.
  
  
  RESULTS
  In healthy subjects, neural component was 0.8 ± 0.9 N (mean ± SD), elastic component was 2.7 ± 1.1 N, viscous component was 0.3 ± 0.3 N and resting tension was 5.9 ± 1 N. Age only correlated with elastic component (r = -0.3, p = 0.01). Elasticity and resting tension were higher in males compared to females (p = 0.001) and both correlated positively with height (p = 0.01). Values above healthy population cut-off were observed in 16 patients (41 %) for neural component, in 2 (5 %) for elastic component and in 23 (59 %) for viscous component. Neural component above cut-off did not correspond well to MAS ratings. Ten patients with MAS = 0 had neural component values above cut-off and five patients with MAS ≥ 1 had neural component within normal range.
  
  
  CONCLUSIONS
  This study provides NeuroFlexor cut-off values that are useful for detection of spasticity in the early phase after stroke.
authors.affiliation: Division of Rehabilitation Medicine, Department of Clinical Sciences Karolinska Institutet, Danderyd University Hospital, Stockholm, SE-182 88, Sweden. gaia.pennati@ds.se.
authors.forename: Gaia Valentina
authors.initials: GV
authors.lastname: Pennati
authors.affiliation: Division of Rehabilitation Medicine, Department of Clinical Sciences Karolinska Institutet, Danderyd University Hospital, Stockholm, SE-182 88, Sweden.
authors.forename: Jeanette
authors.initials: J
authors.lastname: Plantin
authors.affiliation: Division of Rehabilitation Medicine, Department of Clinical Sciences Karolinska Institutet, Danderyd University Hospital, Stockholm, SE-182 88, Sweden.
authors.forename: Jörgen
authors.initials: J
authors.lastname: Borg
authors.affiliation: Division of Rehabilitation Medicine, Department of Clinical Sciences Karolinska Institutet, Danderyd University Hospital, Stockholm, SE-182 88, Sweden.|FR3636 CNRS, Université Paris Descartes, Sorbonne Paris Cité, 75006, Paris, France.|Centre de Psychiatrie et Neurosciences, Inserm U894, 75014, Paris, France.
authors.forename: Påvel G
authors.initials: PG
authors.lastname: Lindberg
mesh_terms: D061725:Accelerometry / Q000295:instrumentation*; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009068:Movement / Q000502:physiology; D009128:Muscle Spasticity / Q000175:diagnosis* / Q000209:etiology; D020521:Stroke / Q000150:complications*
keywords: Biomechanics; Muscle spasticity; Normative data; Stroke; Upper extremity