Parameters that integrated electrophysiological signals with joint movement characteristics were best able to quantify spasticity .
There were conflicting results regarding biomechanical-based parameters that quantify the resistance to passive stretch .
AIM The first aim of this study was to systematic ally review and critically assess manually controlled instrumented spasticity assessment methods that combine multidimensional signals .
The second aim was to extract a set of quantified parameters that are psychometrically sound to assess spasticity in a clinical setting .
Are we underestimating the clinical efficacy of botulinum toxin (type A)? Quantifying changes in spasticity, strength and upper limb function after injections of Botox® to the elbow flexors in a unilateral stroke population
Objective : To quantify the clinical efficacy of botulinum toxin type A in treating elbow flexor spasticity in a unilateral stroke population . Location : A spasticity clinic at a regional neurological rehabilitation centre . Study design : A convenience sample longitudinal study . Fourteen subjects with elbow flexor spasticity secondary to a stroke were recruited . Two repeated measures , one before and another four weeks after treatment , were taken to quantify clinical efficacy . Outcome measures : Elbow flexor spasticity was simultaneously rated with the modified Ashworth scale ( MAS ) and quantified by measuring the surface EMG from the flexors using a custom-built device . Strength at the elbow ( isometric ) , grip strength and upper limb function ( Action Research Arm test ) were also assessed . Treatment : Injections of botulinum toxin type A ( Botox ® ) to the m.biceps brachii ( mean dose 70 U ) , m.brachioradialis ( mean dose 56.5 U ) and m.flexor digitorum longus ( mean dose 83.3 U ) . Results : Following treatment , spasticity ( as measured by flexor EMG activity ) reduced but the MAS was unable to detect this improvement . In some subjects , isometric flexor strength at the elbow as well as grip strength increased . This was contrary to the expected weakening following treatment with botulinum toxin type A and suggests an optimization of motor control . Conclusion : Treatment with Botox ® reduces spasticity but does not necessarily cause a reduction in the force generating capabilities at the joint . The improvement in strength may have contributed to the improvements in upper limb function . The MAS is an inappropriate measure of spasticity
Parameters that integrated electrophysiological signals with joint movement characteristics were best able to quantify spasticity .
There were conflicting results regarding biomechanical-based parameters that quantify the resistance to passive stretch .
AIM The first aim of this study was to systematic ally review and critically assess manually controlled instrumented spasticity assessment methods that combine multidimensional signals .
The second aim was to extract a set of quantified parameters that are psychometrically sound to assess spasticity in a clinical setting .