Background The pendulum test is a standard clinical test for quantifying the severity of spasticity. In the test, an electrogoniometer is typically used to measure the knee angular motion. The device is costly and difficult to set up such that the pendulum test is normally time consuming. Objective The goal of this study is to determine whether a Nintendo Wii remote can replace the electrogroniometer for reliable assessment of the angular motion of the knee in the pendulum test. Methods The pendulum test was performed in three control participants and 13 hemiplegic stroke patients using both a Wii remote and an electrogoniometer. The correlation coefficient and the Bland–Altman difference plot were used to compare the results obtained from the two devices. The Wilcoxon signed-rank test was used to compare the difference between hemiplegia-affected and nonaffected sides in the hemiplegic stroke patients. Results There was a fair to strong correlation between measurements from the Wii remote and the electrogoniometer (0.513 < R2 < 0.800). Small but consistent differences between the Wii remote and electrogoniometer were identified from the Bland–Altman difference plot. Within the hemiplegic stroke patients, both devices successfully distinguished the hemiplegia-affected (spastic) side from the nonaffected (nonspastic) side (both with p < .0001*). In addition, the intraclass correlation coefficient, standard error of measurement, and minimum detectable differences were highly consistent for both devices. Conclusion Our findings suggest that the Wii remote may serve as a convenient and cost-efficient tool for the assessment of spasticity.

BACKGROUND: Whether post-stroke spasticity is associated with autonomic status is unclear. The purpose of our study was to determine whether spasticity in post-stroke patients is associated with heart rate variability (HRV), an indicator of sympathetic and parasympathetic regulation. OBJECTIVE: To determine whether HRV is associated with spasticity in post-stroke patients. METHODS: Our cross-sectional observational study included 21 post-stroke patients with varying degrees of knee spasticity. We measured patients' heart rate variability (HRV) during the morning and afternoon of the same day using the modified Ashworth assessment and the pendulum test. The relationship between HRV and the spasticity parameters was evaluated based on the Pearson correlation coefficient (r). RESULTS:The data for the morning measurements showed that the relaxation index negatively correlated with the high frequency (HF) power of HRV (r = −0.47, P < 0.05), and positively correlated with the low frequency (LF) power of HRV(r = 0.47, P < 0.05) and the LF/HF power ratio (r = 0.55, P < 0.05). Similar correlations were observed between the diurnal differences of HRV and the relaxation index. No correlation was observed among the data for the afternoon measurements. CONCLUSIONS: Higher parasympathetic tone and lower sympathetic tone are associated with a higher degree of knee spasticity in post-stroke patients. Further studies are warranted to confirm our findings and investigate the pathological mechanisms involved.