Test-retest reliability and responsiveness of isokinetic dynamometry to assess wrist flexor muscle spasticity in subacute post-stroke hemiparesis

Dehno, Nasrin Salehi; Kamali, Fahimeh; Shariat, Abdolhamid; Jaberzadeh, Shapour

doi:10.1016/j.jbmt.2020.02.011

Cited by 10 publications

(4 citation statements)

References 32 publications

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“…For the EMG-equipped electronical goniometer, values of MDC% both for short term and long term ranged largely, from 6.13 to 75.19%. For the isokinetic dynamometer, results are comparable to those of this study, with values of MDC% varying from 11 to 21% both for short term and long term [10,34].…”

Section: Reliabilitysupporting

confidence: 83%

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Validity and reliability of the assessment of hand flexors stiffness using a new electromechanical oscillatory device in people with stroke

Selves

Lejeune

Detrembleur

et al. 2023

International Journal of Rehabilitation Research

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Hyper-resistance after a central nervous system injury has been largely referred to as spasticity, which is but one of its neural components. Assessment largely relies on clinical scales (Modified Ashworth scale -MAS and Modified Tardieu scale, MTS) which are unable to distinguish between the non-neural (tissue-related) and the neural (central nervous system-related) components. This study assessed criterion validity and reliability (reproducibility) of muscle stiffness measures, namely, maximum elastic stiffness (ELmax), viscous stiffness (VI), and path length (L-path) in the hand flexor muscles among people with stroke. Measurements were obtained with a wrist-electromechanical oscillatory device (w-EOD). Twenty-four people with arm impairment after stroke were evaluated with the w-EOD and clinical assessment (MAS and MTS), twice on the same day (short-term reliability) and once 10 days later (long-term reliability). For criterion validity, a Spearman coefficient (r) was calculated between stiffness values and the clinical scales. For reliability, intraclass correlation coefficients (ICCs), SEM, and MDC95 were calculated. Moderate correlations were observed between EL max and MAS (r = 0.49) and MTS (V2, r = 0.43; V3, r = 0.49) of the wrist flexors, and finger flexors (MAS, r = 0.60; MTS V2, r = 0.56; MTS V3, r = 0.55). There was a poor correlation between the clinical scales and VI and L-path. Reliability was excellent for all stiffness measurements at short term (EL max : 0.95, VI: 0.94, L-path: 0.92) and good at long term (EL max : 0.87, VI: 0.76, L-path: 0.82). In conclusion, stiffness measurements are valid and reliable to evaluate hyper-resistance in people with stroke.

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Section: Reliabilitysupporting

confidence: 83%

“…In comparison, of the EMG-equipped electronical goniometer (ICCs 0.41-0.92), the NeuroFlexor (ICCs 0.84-0.95), the isokinetic dynamometer (ICCs 0.76-0.85), and ultrasound elastography (ICCs 0.75-0.85) presented a larger variability than in this study [9,[32][33][34].…”

Section: Reliabilitycontrasting

confidence: 65%

Validity and reliability of the assessment of hand flexors stiffness using a new electromechanical oscillatory device in people with stroke

Selves

Lejeune

Detrembleur

et al. 2023

International Journal of Rehabilitation Research

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“…The flexor muscle group is stretched at 180°/s. 33 The dynamometer records the angle of the catch and end as well as the torque of movement-related response.…”

Section: Introductionmentioning

confidence: 99%

IMPROVE study protocol, investigating post-stroke local muscle vibrations to promote cerebral plasticity and functional recovery: a single-blind randomised controlled trial

Julliand,

Papaxanthis,

Delphin

et al. 2024

BMJ Open

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IntroductionSpasticity is a frequent disabling consequence following a stroke. Local muscle vibrations (LMVs) have been proposed as a treatment to address this problem. However, little is known about their clinical and neurophysiological impacts when used repeatedly during the subacute phase post-stroke. This project aims to evaluate the effects of a 6-week LMV protocol on the paretic limb on spasticity development in a post-stroke subacute population.Methods and analysisThis is an interventional, controlled, randomised, single-blind (patient) trial. 100 participants over 18 years old will be recruited, within 6 weeks following a first stroke with hemiparesis or hemiplegia. All participants will receive a conventional rehabilitation programme, plus 18 sessions of LMV (ie, continuously for 30 min) on relaxed wrist and elbow flexors: either (1) at 80 Hz for the interventional group or (2) at 40 Hz plus a foam band between the skin and the device for the control group.Participants will be evaluated at baseline, at 3 weeks and 6 weeks, and at 6 months after the end of the intervention. Spasticity will be measured by the modified Ashworth scale and with an isokinetic dynamometer. Sensorimotor function will be assessed with the Fugl-Meyer assessment of the upper extremity. Corticospinal and spinal excitabilities will be measured each time.Ethics and disseminationThis study was recorded in a clinical trial and obtained approval from the institutional review board (Comité de protection des personnes Ile de France IV, 2021-A03219-32). All participants will be required to provide informed consent. The results of this trial will be published in peer-reviewed journals to disseminate information to clinicians and impact their practice for an improved patient’s care.Trial registration numberClinical Trial:NCT05315726DatasetEUDRAct

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“…The aim of our work was to implement a quantitative assessment for the resistance of the wrist joint to external perturbations, often referred to as mechanical impedance ( Hogan, 1990 ) (i.e., the dynamical relationship between wrist kinematics and torque). Taking into account the ability to quantitatively record kinematic data through robotic systems ( Colombo et al, 2005 ; Salehi Dehno et al, 2020 ), we propose a robotic measurement protocol that delivers sequences of perturbations along the flexion-extension direction of the wrist as in Falzarano et al (2020) to compute the dynamic wrist joint viscoelastic properties. Dynamic is associated with our protocol for evaluating the different components of the mechanical impedance and refers to the fact that the perturbation is sufficient to exclude modifications of the central neural drive.…”

Section: Introductionmentioning

confidence: 99%

Evaluating Viscoelastic Properties of the Wrist Joint During External Perturbations: Influence of Velocity, Grip, and Handedness

Falzarano

Holmes

Masia

et al. 2021

Front. Hum. Neurosci.

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In this study, we designed a robot-based method to compute a mechanical impedance model that could extract the viscoelastic properties of the wrist joint. Thirteen subjects participated in the experiment, testing both dominant and nondominant hands. Specifically, the robotic device delivered position-controlled disturbances in the flexion-extension degree of freedom of the wrist. The external perturbations were characterized by small amplitudes and fast velocities, causing rotation at the wrist joint. The viscoelastic characteristics of the mechanical impedance of the joint were evaluated from the wrist kinematics and corresponding torques. Since the protocol used position inputs to determine changes in mean wrist torque, a detailed analysis of wrist joint dynamics could be made. The scientific question was whether and how these mechanical features changed with various grip demands and perturbation velocities. Nine experimental conditions were tested for each hand, given by the combination of three velocity perturbations (fast, medium, and slow) and three hand grip conditions [self-selected grip, medium and high grip force, as percentage of the maximum voluntary contraction (MVC)]. Throughout the experiments, electromyographic signals of the extensor carpi radialis (ECR) and the flexor carpi radialis (FCR) were recorded. The novelty of this work included a custom-made soft grip sensor, wrapped around the robotic handle, to accurately quantify the grip force exerted by the subjects during experimentation. Damping parameters were in the range of measurements from prior studies and consistent among the different experimental conditions. Stiffness was independent of both direction and velocity of perturbations and increased with increasing grip demand. Both damping and stiffness were not different between the dominant and nondominant hands. These results are crucial to improving our knowledge of the mechanical characteristics of the wrist, and how grip demands influence these properties. This study is the foundation for future work on how mechanical characteristics of the wrist are affected in pathological conditions.

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Test-retest reliability and responsiveness of isokinetic dynamometry to assess wrist flexor muscle spasticity in subacute post-stroke hemiparesis

Cited by 10 publications

References 32 publications

Validity and reliability of the assessment of hand flexors stiffness using a new electromechanical oscillatory device in people with stroke

Validity and reliability of the assessment of hand flexors stiffness using a new electromechanical oscillatory device in people with stroke

IMPROVE study protocol, investigating post-stroke local muscle vibrations to promote cerebral plasticity and functional recovery: a single-blind randomised controlled trial

Evaluating Viscoelastic Properties of the Wrist Joint During External Perturbations: Influence of Velocity, Grip, and Handedness

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