Theoretical and methodological considerations in the measurement of spasticity

Burridge, Jane; Wood, Duncan; Hermens, Hermanus J.; Voerman, Gerlienke; Johnson, Garth; Wijck, Frederike van; Platz, Thomas; Gregorič, M; Hitchcock, R.A.D.; Pandyan, Anand

doi:10.1080/09638280400014592

Cited by 216 publications

(196 citation statements)

References 29 publications

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“…The increase in X V3 in ankle plantarflexors was 6.8° in the 10 U/kg/ leg group and 10.9° in the 15 U/kg/ leg group. As such, we agree with recommendations to use more than just the MAS in the assessment of spasticity 22,23 and confirm the utility 6 by guest on May 12, 2018 http://pediatrics.aappublications.org/ Downloaded from of the Tardieu Scale in pediatric clinical assessment of spasticity. Improvements in muscle tone at both abobotulinumtoxinA doses at week 4 were also associated with a significant overall clinical improvement based on the PGA, and PGA scores were still highly significant at week 12 indicating a carryover of benefit beyond the duration of BoNT-A action.…”

Section: Discussionmentioning

confidence: 72%

AbobotulinumtoxinA for Equinus Foot Deformity in Cerebral Palsy: A Randomized Controlled Trial

et al. 2016

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Section: Discussionmentioning

confidence: 72%

AbobotulinumtoxinA for Equinus Foot Deformity in Cerebral Palsy: A Randomized Controlled Trial

et al. 2016

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“…18 Although the Modified Ashworth Scale is used to measure spasticity in clinical practice and research studies, it measures muscle tone rather than spasticity. The scale has been validated to measure muscle tone at the elbow 121 and although it has been used in some studies to measure tone at other upper limb joints it is unclear how this was undertaken.…”

Section: Measurement Of Spasticitymentioning

confidence: 99%

“…16 Despite the lack of prevalence or prospective cohort studies, upper Because of the complex multifaceted definition, measurement of spasticity is a challenge and no tool covers all aspects of the definition. 18 Clinicians and researchers often measure resistance to passive movement (muscle tone) using a clinical assessment scale, e.g. the Modified Ashworth Scale.…”

Section: Spasticitymentioning

confidence: 99%

BoTULS: a multicentre randomised controlled trial to evaluate the clinical effectiveness and cost-effectiveness of treating upper limb spasticity due to stroke with botulinum toxin type A

Shaw

Rodgers²,

Price³

et al. 2010

Health Technol Assess

163

126

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on behalf of the BoTULS investigatorsHow to obtain copies of this and other HTA programme reports An electronic version of this title, in Adobe Acrobat format, is available for downloading free of charge for personal use from the HTA website (www.hta.ac.uk). A fully searchable DVD is also available (see below).Printed copies of HTA journal series issues cost £20 each (post and packing free in the UK) to both public and private sector purchasers from our despatch agents.Non-UK purchasers will have to pay a small fee for post and packing. For European countries the cost is £2 per issue and for the rest of the world £3 per issue. How to order:-fax (with credit card details) -post (with credit card details or cheque) -phone during office hours (credit card only).Additionally the HTA website allows you to either print out your order or download a blank order form. Contact details are as follows:Synergie UK (HTA Department) Digital House, The Loddon Centre Wade Road Basingstoke Hants RG24 8QW Email: orders@hta.ac.uk Tel: 0845 812 4000 -ask for 'HTA Payment Services' (out-of-hours answer-phone service) Fax: 0845 812 4001 -put 'HTA Order' on the fax header Payment methods Paying by chequeIf you pay by cheque, the cheque must be in pounds sterling, made payable to University of Southampton and drawn on a bank with a UK address. Paying by credit cardYou can order using your credit card by phone, fax or post. SubscriptionsNHS libraries can subscribe free of charge. Public libraries can subscribe at a reduced cost of £100 for each volume (normally comprising 40-50 titles). The commercial subscription rate is £400 per volume (addresses within the UK) and £600 per volume (addresses outside the UK). Please see our website for details. Subscriptions can be purchased only for the current or forthcoming volume. How do I get a copy of HTA on DVD?Please use the form on the HTA website (www.hta.ac.uk/htacd/index.shtml). HTA on DVD is currently free of charge worldwide.The website also provides information about the HTA programme and lists the membership of the various committees. HTA NIHR Health Technology Assessment programmeT he Health Technology Assessment (HTA) programme, part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the effectiveness, costs and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined as all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care. The research findings from the HTA programme directly influence decision-making bodies such as the National Institute for Health and Clinical Excellence (NICE) and the National Screening Committee (NSC). HTA findings also help to improve the quality of clinical practice in the NHS indirectly in that they form a key component of the 'National Knowledge Service'. The HTA programme is needs led in that it fills gaps in the evidence needed by the NHS. There are...

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“…As a consequence, many studies have been conducted using biomechanical and electrophysiological measurements with the objective of evaluating spasticity, and the obtained results have been used to make correlations with the clinical scales (8)(9)(10)(11)(12)(13)(14). Surface electromyography (EMG) has been commonly used in electrophysiological measurements of spasticity (14)(15)(16). However, parameters extracted from surface EMG have been generally obtained from analysis by using only the time domain in previous studies, and results were generally based on correlations with the clinical scales rather than using stand-alone surface EMG as well as considering causality.…”

Section: Introductionmentioning

confidence: 99%

Using fuzzy logic for diagnosis and classification of spasticity

Alcan¹,

Canal²,

Zinnuroğlu³

2017

Turk J Med Sci

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IntroductionSpasticity is a common sensory-motor control disorder characterized by increased velocity-dependent stretch reflex responses resulting from upper motor neuron (UMN) lesions (1). Spasticity is frequently observed in cases such as spinal cord injury, multiple sclerosis, traumatic brain damage, cerebral palsy, and stroke, which can be accompanied by cerebral and spinal pathology that is dispersed or regional (2). The pathophysiology of spasticity is complicated and it is rather difficult to understand the underlying mechanism since it is necessary to know the pathophysiological mechanism that would differentiate the UMN syndrome from other symptoms (3,4). Therefore, spasticity is a disorder that is both insufficiently defined and measured (5). There are three major approaches, clinical, neurophysiological, and biomechanical, for assessing spasticity.The Ashworth Scale (AS) and the modified Ashworth Scale (MAS) are the most commonly used clinical measures of spasticity. The validity, reliability, and sensitivity of the clinical scales, which are subject to interpretation and generally intensified upon passive movement resistance, are debatable (6-8). As a consequence, many studies have been conducted using biomechanical and electrophysiological measurements with the objective of evaluating spasticity, and the obtained results have been used to make correlations with the clinical scales (8-14). Surface electromyography (EMG) has been commonly used in electrophysiological measurements of spasticity (14-16). However, parameters extracted from surface EMG have been generally obtained from analysis by using only the time domain in previous studies, and results were generally based on correlations with the clinical scales rather than using stand-alone surface EMG as well as considering causality. Due to the fact that surface EMG signals are nonstationary and random signals, some pathological data might not be discriminated in the time axis. Therefore, it is possible to utilize the short-time Fourier transform (STFT) and the wavelet transform (WT) methods from the time and the frequency components of the signals found in the pathological symptoms (17,18).Background/aim: Spasticity is generally defined as a sensory-motor control disorder. However, there is no pathophysiological mechanism or appropriate measurement and evaluation standards that can explain all aspects of a possible spasticity occurrence. The objective of this study is to develop a fuzzy logic classifier (FLC) diagnosis system, in which a quantitative evaluation is performed by surface electromyography (EMG), and investigate underlying pathophysiological mechanisms of spasticity.Materials and methods: Surface EMG signals recorded from the tibialis anterior and medial gastrocnemius muscles of hemiplegic patients with spasticity and a healthy control group were analyzed in standing, resting, dorsal flexion, and plantar flexion positions. The signals were processed with different methods: by using their amplitudes in the time domain, by applying short...

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Theoretical and methodological considerations in the measurement of spasticity

Cited by 216 publications

References 29 publications

AbobotulinumtoxinA for Equinus Foot Deformity in Cerebral Palsy: A Randomized Controlled Trial

AbobotulinumtoxinA for Equinus Foot Deformity in Cerebral Palsy: A Randomized Controlled Trial

BoTULS: a multicentre randomised controlled trial to evaluate the clinical effectiveness and cost-effectiveness of treating upper limb spasticity due to stroke with botulinum toxin type A

Using fuzzy logic for diagnosis and classification of spasticity

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