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Clinical biomechanics (Bristol, Avon), 2016
Stretches are often prescribed to manage increased limb stiffness in people with Multiple Scleros... more Stretches are often prescribed to manage increased limb stiffness in people with Multiple Sclerosis. This study determined the ankle plantarflexor torque magnitude that people with Multiple Sclerosis can apply during four commonly prescribed stretches and determined the relationship between the applied torque and functional ability. People with Multiple Sclerosis (N=27) were compared to healthy control participants (n=15). Four stretches were investigated; stretching in step standing; using a step; pulling the ankle into dorsiflexion and standing in a frame. Joint position and forces were measured using 3D motion analysis and torque transducers. Baseline ankle strength and stiffness was measured using motor driven ankle perturbations. People with Multiple Sclerosis (N=27) had higher stretch reflex amplitudes and lower strength compared to the control group (n=15). People with Multiple Sclerosis achieved less lengthening of the plantarflexor muscle-tendon complex when stretching but ...
This copy of the thesis has been supplied on condition that anyone who consults it is understood ... more This copy of the thesis has been supplied on condition that anyone who consults it is understood to recognise that its copyright rests with its author and that no quotation from the thesis and no information derived from it may be published without the author's prior consent.
Hypertonia is seen in 85% of people with Multiple Sclerosis (pwMS) resulting in disability and fu... more Hypertonia is seen in 85% of people with Multiple Sclerosis (pwMS) resulting in disability and functional restrictions. Hypertonia can be caused by increases in passive stiffness and enhanced stretch reflexes (spasticity) and is frequently managed clinically using passive stretches. However, the optimal parameters of stretching such as the applied torque and stretch duration remain unclear. During commonly prescribed ankle plantarflexor stretches pwMS produced higher torques when standing in a weight bearing position compared to stretches applied using the upper limbs. Stretches could be held for 120 seconds on average and stretch duration was mainly limited by fatigue. People with higher disability tended to favour more supported stretching positions. The effects of stretching for either 30 or 10 minutes using a customised motor at three torque levels covering the range that MS participants could produce was investigated. Compared to the 10 minute stretch, greater reductions in pas...
Rehabilitation Process and Outcome
Background: The Multiple Sclerosis Spasticity Scale 88 (MSSS-88) is designed to capture the patie... more Background: The Multiple Sclerosis Spasticity Scale 88 (MSSS-88) is designed to capture the patient experience and impact of spasticity, but there is limited evaluation against clinician-rated measures of spasticity. Objective: To evaluate the convergent validity and responsiveness of the MSSS-88. Design: Longitudinal study. Setting: University Laboratory. Subjects: Thirty-four people with multiple sclerosis. Methods: People with multiple sclerosis (MS; n = 34) completed the self-reported 12-item Multiple Sclerosis Walking Scale, Multiple Sclerosis Spasticity Scale, Barthel Index alongside the clinician-rated Ashworth Scale, and a laboratory-based measure of ankle spasticity. Spasticity measure responsiveness was evaluated in 20 participants at two time points, an average of 8.75 ± 3.8 months apart. Results: In people with MS (mean age 55.1 ± 8.1 years; Expanded Disability Scale range 4.5-7.0), spasticity symptom specific subscales of the MSSS-88 (stiffness and spasms) showed strong...
Clinical biomechanics (Bristol, Avon), 2016
Stretches are often prescribed to manage increased limb stiffness in people with Multiple Scleros... more Stretches are often prescribed to manage increased limb stiffness in people with Multiple Sclerosis. This study determined the ankle plantarflexor torque magnitude that people with Multiple Sclerosis can apply during four commonly prescribed stretches and determined the relationship between the applied torque and functional ability. People with Multiple Sclerosis (N=27) were compared to healthy control participants (n=15). Four stretches were investigated; stretching in step standing; using a step; pulling the ankle into dorsiflexion and standing in a frame. Joint position and forces were measured using 3D motion analysis and torque transducers. Baseline ankle strength and stiffness was measured using motor driven ankle perturbations. People with Multiple Sclerosis (N=27) had higher stretch reflex amplitudes and lower strength compared to the control group (n=15). People with Multiple Sclerosis achieved less lengthening of the plantarflexor muscle-tendon complex when stretching but ...
This copy of the thesis has been supplied on condition that anyone who consults it is understood ... more This copy of the thesis has been supplied on condition that anyone who consults it is understood to recognise that its copyright rests with its author and that no quotation from the thesis and no information derived from it may be published without the author's prior consent.
Hypertonia is seen in 85% of people with Multiple Sclerosis (pwMS) resulting in disability and fu... more Hypertonia is seen in 85% of people with Multiple Sclerosis (pwMS) resulting in disability and functional restrictions. Hypertonia can be caused by increases in passive stiffness and enhanced stretch reflexes (spasticity) and is frequently managed clinically using passive stretches. However, the optimal parameters of stretching such as the applied torque and stretch duration remain unclear. During commonly prescribed ankle plantarflexor stretches pwMS produced higher torques when standing in a weight bearing position compared to stretches applied using the upper limbs. Stretches could be held for 120 seconds on average and stretch duration was mainly limited by fatigue. People with higher disability tended to favour more supported stretching positions. The effects of stretching for either 30 or 10 minutes using a customised motor at three torque levels covering the range that MS participants could produce was investigated. Compared to the 10 minute stretch, greater reductions in pas...
Rehabilitation Process and Outcome
Background: The Multiple Sclerosis Spasticity Scale 88 (MSSS-88) is designed to capture the patie... more Background: The Multiple Sclerosis Spasticity Scale 88 (MSSS-88) is designed to capture the patient experience and impact of spasticity, but there is limited evaluation against clinician-rated measures of spasticity. Objective: To evaluate the convergent validity and responsiveness of the MSSS-88. Design: Longitudinal study. Setting: University Laboratory. Subjects: Thirty-four people with multiple sclerosis. Methods: People with multiple sclerosis (MS; n = 34) completed the self-reported 12-item Multiple Sclerosis Walking Scale, Multiple Sclerosis Spasticity Scale, Barthel Index alongside the clinician-rated Ashworth Scale, and a laboratory-based measure of ankle spasticity. Spasticity measure responsiveness was evaluated in 20 participants at two time points, an average of 8.75 ± 3.8 months apart. Results: In people with MS (mean age 55.1 ± 8.1 years; Expanded Disability Scale range 4.5-7.0), spasticity symptom specific subscales of the MSSS-88 (stiffness and spasms) showed strong...