The Use of a Portable Muscle Tone Measurement Device to Measure the Effects of Botulinum Toxin Type A on Elbow Flexor Spasticity

Chen, Jia Jin Jason; Wu, Yi-Ning; Huang, Sheng Chieh; Lee, Hsin-Min; Wang, Yu Lin

doi:10.1016/j.apmr.2005.03.019

Cited by 56 publications

(69 citation statements)

References 22 publications

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“…Control limbs ( ferences in biomechanical measures of resistance were previously reported in patients with spasticity by use not only hand-held (Malouin et al, 1989;Claude et al, 1992;Boiteau et al, 1995;Chen et al, 2005), but also with isokinetic torque-motor devices (Knutsson and Martensson, 1980;Bromberg and Grimby, 1983;Engsberg et al, 1996;Firoozbakhsh et al, 1993). In contrary to the substantial increase in resistance which was reported for the of the ankle joint of stroke patients (Lamontagne et al, 1997;Kim et al, 2005).…”

Section: Spastic Limbs (P) (N = 31)mentioning

confidence: 91%

“…Even with the application of isokinetic torque devices, there is a lack of standardized protocols, EMG muscle analysis is lacking during many tests, and the reliability of the devices is uncertain (Firoozbakhsh et al, 1993). Relatively simple, portable hand-held devices have been used to determine the resistance of ankle (Boiteau et al, 1995;Malouin et al, 1989;Tardieu et al, 1968), and hip (Claude et al, 1992) joints in children with cerebral palsy, knee joint in patients with spasticity (Stein et al, 1996), and elbow joints in patients with Parkinson's disease (Prochazka et al, 1997) and stroke (Lee et al, 2002;Chen et al, 2005). However, portable methods have rarely been used to determine velocity-dependent changes of resistance in patients with spasticity at full available range of the motion (Tardieu et al, 1968;Lee et al, 2002).…”

Section: Introductionmentioning

confidence: 99%

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Knee resistance during passive stretch in patients with hypertonia

Lebiedowska

Fisk

2009

Journal of Neuroscience Methods

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Section: Spastic Limbs (P) (N = 31)mentioning

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Knee resistance during passive stretch in patients with hypertonia

Lebiedowska

Fisk

2009

Journal of Neuroscience Methods

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“…Furthermore, we applied our approach to evaluate the effects of botulinum toxin type A (BTX-A) on spastic elbow flexors [6,7]. BTX-A has been used for spasticity reduction because of its localized effect and convenience.…”

Section: Editorialmentioning

confidence: 99%

“…From viscous components at four different stretch frequencies (1/3, 1/2, 1 and 3/2 Hz), averaged viscosity denoting the velocity-dependence of joint properties was used to differentiate normal muscle tone and hypertonia. These findings suggest that measurements of viscous component and averaged viscosity during manual sinusoidal stretching using the portable device could be clinically useful in evaluating spasticity.Furthermore, we applied our approach to evaluate the effects of botulinum toxin type A (BTX-A) on spastic elbow flexors [6,7]. BTX-A has been used for spasticity reduction because of its localized effect and convenience.…”

mentioning

confidence: 99%

Evolution of Quantitative Approaches for Muscle Spasticity Measurement

Lee¹

2016

Int J Phys Med Rehabil

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EditorialAbout 20 years ago, I first joined the spasticity measurement research group at biosignal laboratory (leaded by Dr. Jia-Jin Jason Chen) of Institute of Biomedical Engineering, National Cheng Kung University. At that time, the limitation of clinical approach for spasticity evaluation was initially noted by the researchers [1]. We developed our first quantitative measurement system based on driven motor and torque sensor to precisely measure the reactive resistance of elbow flexors during constant-velocity stretches [2]. We also proposed a parameter (ASRT, averaged speed-dependent reflex torque) to overcome the gravity and inertia problems in vertical stretch circumstance and to quantify the elbow spasticity of stroke patients under the constant-velocity stretch. During the development of spasticity, the changes of ASRT and velocity sensitivity of ASRT (i.e. velocity-dependent properties) of the involved and the intact elbow joints are presented and discussed in the same article [2].Furthermore, we used the measurement system to evaluate the different features between muscle spasticity and rigidity [3]. Spasticity and rigidity are two major hypertonias found in patients with lesions of the upper motor neurons. Without quantitative approach, we commonly differentiate these two hypertonias with clinical experience. In our study, elbow flexors were vertically stretched under four different velocities (40, 80, 120, and 160°/s) through a 75° range of motion in 12 hemiparetic and 16 parkinsonism patients. With velocity dependence analysis, we found very interesting results indicating that rigidity and spasticity have approximately equal velocity dependent properties. In contrast, position dependent properties might be one of the main features to differentiate between these two hypertonias.The motor-based system is excellent in its precise stretch with selected constant-velocity to eliminate the effect of inertia, but the bulky system is obviously not suitable to be online used in clinics. With the knowledge and experience of our motor-based system, a hand-held device was developed [4]. Light-weight air-bag cuffs with a differential pressure sensor and a goniometer were used to measure the resistance and displacement of elbow joint during to-and-fro stretches. Before it was used in stroke patients, three simulation modules representing inertia, damper, and spring modules were evaluated and validated for measurement of reactive resistance and displacement during manual evaluation. We applied the concept used in dynamic shear rheometer test for mechanical analysis of material [5] to decompose viscous component of spastic muscle. From viscous components at four different stretch frequencies (1/3, 1/2, 1 and 3/2 Hz), averaged viscosity denoting the velocity-dependence of joint properties was used to differentiate normal muscle tone and hypertonia. These findings suggest that measurements of viscous component and averaged viscosity during manual sinusoidal stretching using the portable device could be clinically usef...

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“…Além do reflexo do estiramento muscular dependente da velocidade em que há o aumento da resistência à movimentação passiva, a espasticidade tem como consequências a restrição da amplitude articular, o que interfere na função motora dificultando atividades, causando dor, desconforto muscular, deformidades ou mesmo contraturas (CHEN, et al, 2005;COSTA et al, 2010;LEE et al, 2008;RODGERS et al, 2010;TIEVE;ZONTA;KUMAGAI, 1998).…”

Section: Espasticidade E Alteração De Forçaunclassified

Validação do instrumento de medida da resistência da musculatura espástica flexora de punho e dedos

Carrijo¹

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The Use of a Portable Muscle Tone Measurement Device to Measure the Effects of Botulinum Toxin Type A on Elbow Flexor Spasticity

Cited by 56 publications

References 22 publications

Knee resistance during passive stretch in patients with hypertonia

Knee resistance during passive stretch in patients with hypertonia

Evolution of Quantitative Approaches for Muscle Spasticity Measurement

Validação do instrumento de medida da resistência da musculatura espástica flexora de punho e dedos

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