title: Ankle plantarflexor spasticity is not differentially disabling for those who are weak following traumatic brain injury.
abstract: The main aim of this study was to determine whether the presence of distal lower-limb spasticity had a greater impact on mobility for those who had greater levels of muscle paresis following traumatic brain injury (TBI).
  
  
  
  This was a cross-sectional cohort study of convenience. Seventy-five people attending physiotherapy for mobility limitations following TBI participated in this study. All participants had sustained a moderate-severe TBI and were grouped according to the presence or absence of ankle plantarflexor spasticity for comparison.
  
  
  
  The primary outcome measure for mobility was self-selected walking speed and the primary outcome measure for muscle strength was hand-held dynamometry. Secondary outcome measures for mobility and muscle strength were the High-level Mobility Assessment Tool (HiMAT) and ankle power generation (APG) at push-off. Spasticity was quantified with the Modified Tardieu scale. Participants with ankle plantarflexor spasticity (Group 2) had slower self-selected walking speeds. There was no statistically significant effect for Group and plantarflexor strength (p = 0.81).
  
  
  
  Although participants with ankle plantarflexor spasticity walked significantly slower than those without, the presence of ankle plantarflexor spasticity did not lead to greater mobility limitations for those who were weak.
authors.affiliation: a Epworth Hospital , Melbourne , Australia.|b The University of Melbourne , Melbourne , Australia.
authors.forename: Gavin
authors.initials: G
authors.lastname: Williams
authors.affiliation: a Epworth Hospital , Melbourne , Australia.
authors.forename: Megan
authors.initials: M
authors.lastname: Banky
authors.affiliation: c Research Development & Governance , Epworth HealthCare , Melbourne , Australia.|d School of Nursing and Midwifery , Deakin University , Melbourne , Australia.
authors.forename: Dean
authors.initials: D
authors.lastname: McKenzie
authors.affiliation: e Epworth Monash Rehabilitation Medicine Unit , Melbourne , Australia.
authors.forename: John
authors.initials: J
authors.lastname: Olver
mesh_terms: D000293:Adolescent; D000328:Adult; D000843:Ankle Joint / Q000503:physiopathology*; D000070642:Brain Injuries, Traumatic / Q000150:complications* / Q000503:physiopathology; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D005684:Gait / Q000502:physiology; D006801:Humans; D008297:Male; D051346:Mobility Limitation; D009128:Muscle Spasticity / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D053580:Muscle Strength / Q000502:physiology; D053581:Muscle Strength Dynamometer; D018908:Muscle Weakness / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D020127:Recovery of Function / Q000502:physiology; D012720:Severity of Illness Index; D016138:Walking / Q000502:physiology*; D055815:Young Adult
keywords: Ankle power generation; gait; mobility limitation; muscle spasticity; muscle weakness; traumatic brain injury