Responsiveness and minimal clinically important difference of Modified Ashworth Scale in patients with stroke

Chen, Chia‐Ling; Chen, Chung-Yao; Chen, Hsieh-Ching; Wu, Ching‐yi; Lin, Keh‐chung; Hsieh, Yu‐Wei; Shen, I-Hsuan

doi:10.23736/s1973-9087.19.05545-x

Cited by 70 publications

(62 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…For secondary outcomes, pain was evaluated by visual analogue scale and passive range of motion by a goniometer. A clinical change in the Modified Ashworth Scale was noted, according to the parameters of Chen et al 35 and part of the change was maintained over the long term, consistent with the results of Jia et al 36 The results of this review support the hypothesis that extracorporeal shock waves influence the non-neural component of spasticity, and improve myofascial viscoelasticity, muscle stiffness and connective tissue. Our data show that a combination of shockwave therapy and conventional physiotherapy is more effective in reducing muscle tension in spastic muscles.…”

Section: Discussionsupporting

confidence: 85%

The effectiveness of extracorporeal shock wave therapy for improving upper limb spasticity and functionality in stroke patients: a systematic review and meta-analysis

et al. 2020

View full text Add to dashboard Cite

Objective: To assess the effectiveness of Extracorporeal Shock Wave Therapy for reducing spasticity and improving functionality of the upper limb in stroke survivors. Data sources: A systematic review of MEDLINE, Cochrane Central Register of Controlled Trials, CINAHL, PEDro, REHABDATA, Scielo, Scopus, Web of Science, Tripdatabase and Epistemonikos from 1980 to April 2020 was carried out. Review methods: The bibliography was screened to identify randomized controlled clinical trials that applied extracorporeal shock waves to upper limb spastic muscles in post-stroke individuals. Two reviewers independently screened references, selected relevant studies, extracted data and assessed risk of bias using the PEDro scale. The primary outcome was spasticity and functionality of the upper limb. Results: A total of 1,103 studies were identified and 16 randomized controlled trials were finally included (764 individuals) were analyzed. A meta-analysis was performed and a beneficial effect on spasticity was found. The mean difference (MD) on the Modified Ashworth Scale for comparison extracorporeal shock wave versus sham was −0.28; with a 95% confidence interval (CI) from −0.54 to −0.03. The MD of the comparison of extracorporeal shock wave plus conventional physiotherapy versus conventional physiotherapy was −1.78; 95% CI from −2.02 to −1.53. The MD for upper limb motor-function using the Fugl Meyer Assessment was 0.94; 95% CI from 0.42 to 1.47 in the short term and 0.97; 95% CI from 0.19 to 1.74 in the medium term. Conclusion: The extracorporeal shock wave therapy is effective for reducing upper limb spasticity. Adding it to conventional therapy provides an additional benefit.

show abstract

Section: Discussionsupporting

confidence: 85%

The effectiveness of extracorporeal shock wave therapy for improving upper limb spasticity and functionality in stroke patients: a systematic review and meta-analysis

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Scale is graded from 0 to 4 and presented as: 0, no increase in muscle tone, with limb moving freely; 1, slight increase in muscle tone, with a catch and release or minimal resistance at the end of the ROM during flexion and extension; 1+, slight increase in muscle tone with a catch and minimal resistance throughout the remainder (less than half) of the ROM; 2, more marked increase in muscle tone through most of the ROM, with affected limb moving easily; 3, considerable increase in muscle tone, with difficulty in passive movement; 4, limited joint movement. Maximum score in the study was 5, and the 1+ was converted to 2 [16].…”

Section: Behavioral Assaysmentioning

confidence: 99%

Waggle needling wields preferable neuroprotective and anti-spastic effects on post-stroke spasticity rats by attenuating γ-aminobutyric acid transaminase and enhancing γ-aminobutyric acid.

Wang¹,

Mu²,

Ma³

et al. 2020

NeuroReport

View full text Add to dashboard Cite

Waggle needling, a classical anti-spastic needling technique characterized by combination of acupuncture with joint movement, has gained increasing popularity of spasticity treatment in China. This study was designed to compare the anti-spastic effect of waggle needling to the routine needling and to explore its underlying mechanism. We established post-stroke spasticity model based on ischemia stroke operation (middle cerebral artery occlusion). Rats were divided into six groups: normal control group, sham-operated control group, ischemia stroke model group, waggle needling group, routine needling group and baclofen group. Neurological function and muscle tone were assessed by the Zea Longa score and modified Ashworth scale, respectively. Indirect muscle tone was testified with electrophysiological recording. Cerebral infarction was measured by 2,3,5-triphenyltetrazolium chloride staining. The concentrations and expressions of γ-aminobutyric acid transaminase (GABAT) and γ-aminobutyric acid (GABA) were detected by enzyme-linked immunosorbent assay and western blot assay. Waggle needling markedly alleviated neurological deficits, decreased cerebral infarction and eased muscle tone; simultaneously, attenuated GABAT and enhanced GABA expression in the cortical infarct regions in comparison with the routine needling (P < 0.01), yet showed similar therapeutic effect to the baclofen group (P > 0.05). These results preliminary supported that waggle needling as a potential promising non-pharmacological intervention for the treatment of cerebral ischemia and spasticity.

show abstract

“…Canadian Occupational Performance Measure (COPM) (Van Heest et al., 2015). Modified Ashworth Scale (MAS) (Chen et al., 2019). Disability Assessment Scale (DAS) (Brashear et al., 2002).…”

Section: Patient Evaluationmentioning

confidence: 99%

Preferred options and evidence for upper limb surgery for spasticity in cerebral palsy, stroke, and brain injury

Tranchida

Heest

2019

J Hand Surg Eur Vol

View full text Add to dashboard Cite

Surgical interventions for the spastic upper extremity secondary to stroke, traumatic brain injury, and cerebral palsy aim to correct the common deformities of elbow flexion, forearm pronation, wrist and finger flexion, ulnar deviation, and thumb-in-palm deformity. After appropriate evaluation, as well as determining the goals of surgery, deformity correction can be achieved through single-event, multi-level surgery. Surgery includes a combination of soft tissue lengthening, tendon transfer, and joint stabilization procedures. Surgical treatment for shoulder adduction/internal rotation, elbow flexion, forearm pronation, wrist flexion, thumb-in-palm, and clenched fist deformities due to spasticity are discussed, and treatment outcomes are reviewed.

show abstract

Responsiveness and minimal clinically important difference of Modified Ashworth Scale in patients with stroke

Cited by 70 publications

References 39 publications

The effectiveness of extracorporeal shock wave therapy for improving upper limb spasticity and functionality in stroke patients: a systematic review and meta-analysis

The effectiveness of extracorporeal shock wave therapy for improving upper limb spasticity and functionality in stroke patients: a systematic review and meta-analysis

Waggle needling wields preferable neuroprotective and anti-spastic effects on post-stroke spasticity rats by attenuating γ-aminobutyric acid transaminase and enhancing γ-aminobutyric acid.

Preferred options and evidence for upper limb surgery for spasticity in cerebral palsy, stroke, and brain injury

Contact Info

Product

Resources

About