Posture Influence on the Pendulum Test of Spasticity in Patients with Spinal Cord Injury

Abstract

The study aims to investigate the influence of different postures on spasticity results by pendulum test in patients with spinal cord injury (SCI). The setting was at the University of Campinas (UNICAMP), Campinas, SP, Brazil. Five individuals with SCI and five individuals in the control group were included. All individuals went through the pendulum test in three different positions: supine, semi-supine at an angle of 30°, and sitting up at an angle of 60°. An electrogoniometer was attached to the right leg for measurement of knee joint angles. All situations were performed five times. Blood pressure was monitored during tests. Relaxation index (RI), normalized relaxation index (RIn), test duration in seconds, initial flexion angle, and resting angle were analyzed at three different positions. Results were compared between different positions, and statistically no differences were found. In individuals with SCI, RI (1.83 ± 0.2), RIn (1.14 ± 0.13), and test duration values (13.95 ± 4.14), in sitting up position, were similar to the control group results. In sitting up position, patients showed spasticity reduction. However, the other two postures produce pain and increase blood pressure in patients with tetraplegia. Therefore, these postures should be avoided in patients with lesions above T6, due to possible autonomic dysreflexia symptoms.

Predictive value of the pendulum test for assessing knee extensor spasticity

“…Several studies have shown feasibility of using sensor technologies with an instrumented pendulum test [ 19 , 21 , 28 ] and repeatability and validity for assessing spasticity in patients has generally been reported as positive [ 25 , 29 , 30 ]. Although the test has some drawbacks [ 31 ], such as being sensitive to posture during the test [ 32 , 33 ], clinical evidence is increasing that the pendulum test has value for objectively quantifying spasticity of knee extensors [ 34 – 39 ], as well as flexors and extensor of the elbow [ 40 , 41 ].…”

Comparison of Single-Session Dose Response Effects of Whole Body Vibration on Spasticity and Walking Speed in Persons with Spinal Cord Injury

“…The pendulum test was performed with subjects in a semireclined position on an adjustable height mat table. Prior work has indicated that similar pendulum test outcomes are produced in individuals with SCI when tested in the fully reclined and semi-reclined positions [24], and the latter position is more comfortable. The test leg was flexed at the knee and hanging over the edge of the mat, the nontest leg was supported on a chair with the knee in extension.…”

Imbalanced Corticospinal and Reticulospinal Contributions to Spasticity in Humans with Spinal Cord Injury

“…1A). This neutral position helps to avoid increases in spasticity related to the stretching of the rectus femoris or the decrease of spasticity related to less stretched and more relaxed muscle (de Azevedo et al, 2015). The same rater performed all MAS assessments.…”