Role of Spasticity Severity in the Balance of Post-stroke Patients

Abstract

Background: Lower limb spasticity after stroke is common that can affect the balance, increase the risk of falling, and reduces the quality of life.Objective: First, evaluate the effects of spasticity severity of ankle plantar flexors on balance of patients after stroke. Second, to determine the relationship between the spasticity severity with ankle proprioception, passive ankle dorsiflexion range of motion (ROM), and balance confidence.Methods: Twenty-eight patients with stroke based on the Modified Modified Ashworth Scale (MMAS) were divided into two groups: High Spasticity Group (HSG) (MMAS > 2) (n = 14) or a Low Spasticity Group (LSG) (MMAS ≤ 2) (n = 14). The MMAS scores, Activities-Specific Balance Confidence Questionnaire, postural sway of both affected and non-affected limbs under the eyes open and eyes closed conditions, timed up and go (TUG) test, passive ankle dorsiflexion ROM, and ankle joint proprioception were measured.Results: The ankle joint proprioception was significantly better in the LSG compared to the HSG (p = 0.01). No significant differences were found between the LSG and HSG on all other outcome measures. There were no significant relationships between the spasticity severity and passive ankle dorsiflexion ROM, and balance confidence.Conclusion: The severity of ankle plantar flexor spasticity had no effects on balance of patients with stroke. However, the ankle joint proprioception was better in patients with low spasticity. Our findings suggest that the balance is affected regardless of the severity of the ankle plantar flexor spasticity in this group of participants with stroke.

Variation in the rate of recovery in motor function between the upper and lower limbs in patients with stroke: some proposed hypotheses and their implications for research and practice

“…However, as noted earlier, spasticity in the upper limb is significantly associated with poor dexterity, a requirement for fine motor movement ability ( 39 , 65 ). Moreover, spasticity is associated with decreased joint proprioception ( 67 ). Acuity of proprioception in the wrist joint is linked to the control of fine movement ( 66 ).…”

Gender and limb effects on adult normative data for the Biodex Balance System

“…During data collection, initially, participants were assessed using a self-reported leg dominance questionnaire (van Melick, et al, 2017). This implies that participants had to identify the leg which is mostly utilised when kicking the ball to a maximum distance (Mahmoudzadeh, et al, 2021). The preprogrammed "Postural Stability Test" on the Biodex Balance System (Model 950-440, Biodex Medical Systems, Inc., Shirley, New York) was used to assess both static and dynamic balance (Cachupe, Shifflett, Kahanov, & Wughalter, 2001;Karimi, Ebrahimi, Kahrizi, & Torkaman, 2008;Parraca, et al, 2011).…”

The mechanism of Sangdantongluo granule in treating post-stroke spasticity based on multimodal fMRI combined with TMS: Study protocol

“…Research shows that spasms occur in the early stages of stroke at a rate of 4–40 % [ [4] , [5] , [6] , [7] , [8] ]. Inadequate treatment often leads to limb muscle contracture pain and joint deformation, obstructing the recovery of affected limb function and further reducing the patient’s quality of life [ 9 , 10 ].…”