Article

Quantitative evaluations of ankle spasticity and stiffness in neurological disorders using manual spasticity evaluator.

Rehabilitation Institute of Chicago, Chicago, IL 60611, USA.
The Journal of Rehabilitation Research and Development (Impact Factor: 1.69). 01/2011; 48(4):473-81. DOI: 10.1682/JRRD.2010.04.0053
Source: PubMed

ABSTRACT Spasticity and contracture are major sources of disability in people with neurological impairments that have been evaluated using various instruments: the Modified Ashworth Scale, tendon reflex scale, pendulum test, mechanical perturbations, and passive joint range of motion (ROM). These measures generally are either convenient to use in clinics but not quantitative or they are quantitative but difficult to use conveniently in clinics. We have developed a manual spasticity evaluator (MSE) to evaluate spasticity/contracture quantitatively and conveniently, with ankle ROM and stiffness measured at a controlled low velocity and joint resistance and Tardieu catch angle measured at several higher velocities. We found that the Tardieu catch angle was linearly related to the velocity, indicating that increased resistance at higher velocities was felt at further stiffer positions and, thus, that the velocity dependence of spasticity may also be position-dependent. This finding indicates the need to control velocity in spasticity evaluation, which is achieved with the MSE. Quantitative measurements of spasticity, stiffness, and ROM can lead to more accurate characterizations of pathological conditions and outcome evaluations of interventions, potentially contributing to better healthcare services for patients with neurological disorders such as cerebral palsy, spinal cord injury, traumatic brain injury, and stroke.

1 Bookmark
 · 
72 Views
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Spasticity and muscular hypertonus are frequently found in stroke survivors and may have a significant effect on functional impairment. These abnormal neuro-muscular properties, which are quantifiable by the net impedance of the hand, have a direct consequence on arm mechanics and are likely to produce anomalous motor paths. Literature studies quantifying limb impedance in stroke survivors have focused on multijoint static tasks and single joint movements. Despite this research, little is known about the role of sensory motor integration in post-stroke impedance modulation. The present study elucidates this role by integrating an evaluation of arm impedance into a robotically mediated therapy protocol. Our analysis had three specific objectives: 1) obtaining a reliable measure for the mechanical proprieties of the upper limb during robotic therapy; 2) investigating the effects of robot assisted training and visual feedback on arm stiffness and viscosity; 3) determining if the stiffness measure and its relationship with either training or visual feedback depend on arm position, speed, and level of assistance. This work demonstrates that the performance improvements produced by minimally assistive robot training are associated with decreased viscosity and stiffness in stroke survivors paretic arm and that these mechanical impedance components are partially modulated by visual feedback.
    IEEE transactions on neural systems and rehabilitation engineering: a publication of the IEEE Engineering in Medicine and Biology Society 11/2012; · 2.42 Impact Factor
  • Source
    The Journal of Rehabilitation Research and Development 01/2011; 48(4):vii-x. · 1.69 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: This article provides a comprehensive review of studies that investigated ankle assessment techniques to better understand those that can be used in the real-time monitoring of rehabilitation progress for implementation in conjunction with robot-assisted therapy. Seventy-six publications published between January 1980 and August 2013 were selected based on eight databases. They were divided into two main categories (16 qualitative and 60 quantitative studies): 13 goniometer studies, 18 dynamometer studies, and 29 studies about innovative techniques. A total of 465 subjects participated in the 29 quantitative studies of innovative measurement techniques that may potentially be integrated in a real-time monitoring device, of which 19 studies included less than 10 participants. Results show that qualitative ankle assessment methods are not suitable for real-time monitoring in robot-assisted therapy, though they are reliable for certain patients, while the quantitative methods show great potential. The majority of quantitative techniques are reliable in measuring ankle kinematics and kinetics but are usually available only for use in the sagittal plane. Limited studies determine kinematics and kinetics in all three planes (sagittal, transverse, and frontal) where motions of the ankle joint and the subtalar joint actually occur.
    The Journal of Rehabilitation Research and Development 01/2014; 51(4):517-534. · 1.69 Impact Factor

Full-text

Download
9 Downloads
Available from
Sep 10, 2014
Available from