Robotic pilot study for analysing spasticity: clinical data versus healthy controls (original) (raw)
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Biomechanical examination of a commonly used measure of spasticity
Clinical Biomechanics, 2001
Background. An increase in the prevalence of neurological disability puts pressure on service providers to restrict costs associated with rehabilitation. Spasticity is an important neurological impairment for which many novel and expensive treatment options now exist. The antispastic eects of these techniques remain unexplored due to a paucity of valid outcome measures. Aim. To develop a biomechanical measure of resistance to passive movement, which could be used in routine clinical practice, and to examine the validity of the modi®ed Ashworth scale. Study design. Repeated measure cross-section study on 16 subjects who had a unilateral stroke one-week previously and had no elbow contractures. Outcome measures. Simultaneous measurement of resistance to passive movement using a custom built measuring device and the modi®ed Ashworth scale. Passive range of movement and velocity were also measured. The``catch'', a phenomenon associated with the modi®ed Ashworth scale, was identi®ed by the assessor using a horizontal visual analogue scale and biomechanically quanti®ed using the residual calculated from a linear regression technique. Results. Half the study population had a modi®ed Ashworth score greater than zero. The association between the two measures was poor (j 0:366). The speed and range of passive movement were greater in subjects with modi®ed Ashworth score``0'' (P < 0:05). Resistance to passive movement was higher in the impaired arm (P < 0:05) and tended to decrease with repeated measures and increasing speeds. Conclusions. A device to measure resistance to passive movement at the elbow was developed. The modi®ed Ashworth scale may not provide a valid measure of spasticity but a measure of resistance to passive movement in an acute stroke population. Relevance Spasticity is an important neurological impairment for which many novel and expensive treatment options are being made available. There is a paucity of clinically usable outcomes to measure spasticity. A device to measure resistance to passive movement at the elbow, which was more reliable than the modi®ed Ashworth scale was developed. This device may provide a much needed objective clinical measure to evaluate the ecacy of antispasticity treatment.
Frontiers in Bioengineering and Biotechnology
Background: Despite recent developments in the methodology for measuring spasticity, the discriminative capacity of clinically diagnosed spasticity has not been well established. This study aimed to develop a simple device for measuring velocity-dependent spasticity with improved discriminative capacity based on an analysis of clinical maneuver and to examine its reliability and validity.Methods: This study consisted of three experiments. First, to determine the appropriate motion of a mechanical device for the measurement of velocity-dependent spasticity, the movement pattern and the angular velocity used by clinicians to evaluate velocity-dependent spasticity were investigated. Analysis of the procedures performed by six physical therapists to evaluate spasticity were conducted using an electrogoniometer. Second, a device for measuring the resistance force against ankle dorsiflexion was developed based on the results of the first experiment. Additionally, preliminary testing of va...
Clinical Rehabilitation, 2008
Objective: To quantify agreement between three clinically usable methods of measuring spasticity. Methods: Patients with a first stroke who had no useful functional movement in the upper limb within six weeks from stroke onset were eligible to participate. Spasticity at the wrist joint was simultaneously measured using three methods, during an externally imposed passive stretch at two (uncontrolled) displacement velocities. The measures used were a common clinical measure (modified Ashworth Scale), a biomechanical measure (resistance to passive movement) and a neurophysiological measure (muscle activity). Results: One hundred patients (54 men and 46 women) with a median age of 74 years (range 43-91) participated. Median time since stroke was three weeks (range 1-6), the right side was affected in 52 patients and the left in 48 patients. Based on muscle activity measurement, 87 patients had spasticity. According to the modified Ashworth score 44 patients had spasticity. Sensitivity of modified Ashworth score, when compared with muscle activity recordings, was 0.5 and specificity was 0.92. Based on muscle activity patterns, patients could be classified into five subgroups. The biomechanical measures showed no consistent relationship with the other measures. Conclusion: The presentations of spasticity are variable and are not always consistent with existing definitions. Existing clinical scales that depend on the quantification of muscle tone may lack the sensitivity to quantify the abnormal muscle activation and stiffness associated with common definitions of spasticity. Neurophysiological measures may provide more clinically useful information for the management and assessment of spasticity.
Procedia Computer Science, 2019
Spasticity is a neurological disorder that harms individuals affected by it in many aspects. Thus, in an attempt to restore their normal functions, patients are referred to rehabilitation. However, as a fundamental requirement of any treatment, it is important to obtain a reliable diagnosis to propose a treatment consistent with the actual need of the patient. This study aimed to know about the therapists that treat spasticity, their satisfaction degree related to the applied assessment methodology, and if they are interested in an equipment that could provide objective results. A questionnaire was formulated and released in Google Forms platform. It was applied from January to February of 2018 and answered by 102 health care professionals. The results identified that the known and used methods by therapists for clinical evaluation of spasticity depends on their expertise and are considered subjective evaluations. Also, more than 92% of the health care professionals, who answered the questionnaire are interested in dedicated equipment to measure spasticity in clinical practice. Thus, confirming the demand of them by portable equipment that is easy to handle and of high reliability to measure spasticity in practice.
The spasticity evaluation test (SeT): a pilot study
Journal of rehabilitation research and development
This paper addresses the development of an apparatus designed to evaluate clinically the presence of spasticity affecting the elbow. The biomechanical contributions due to the lever-arm muscles and to the gravity force are accounted for using software algorithms that express gravity force and lever arm as functions of the elbow angle and are able to provide information on the force exerted by the muscles at a known speed. The preliminary data indicate that the device can be applied easily in the clinical setting. Further studies are required to demonstrate conclusively the validity and reliability of this device in quantifying spasticity at the elbow.
Spasticity-assessment: a review
Spinal Cord, 2006
Study design: Review of the literature on the validity and reliability of assessment of spasticity and spasms. Objectives: Evaluate the most frequently used methods for assessment of spasticity and spasms, with particular focus on individuals with spinal cord lesions.
Clinical and Electromechanical Methods of Spasticity Assessment: A Review
Zenodo (CERN European Organization for Nuclear Research), 2018
Spasticity is a neurological disorder which results in disordered sensorimotor control owing to an upper motor neuron lesion. The muscles are continuously contracted which causes stiffness in the muscle which hinders the movement of muscle from their natural movement. It is mainly caused due to an injury to the central nervous system. Commonly used assessment methods of spasticity like the Ashworth and modified Ashworth scales do not quantify the degree of spasticity in the patients as they simply make available a semi quantitative degree of the force applied by the foot as resistance to passive movement with restricted inter-rater reliability. Electromechanical methods like isokinetic dynamometers can be used only when an objective quantitative weigh is available for the resistance to passive motion. Electrophysiological methods are valuable for the understanding of the pathophysiological procedures tangled in spasticity. But none of the methods are easy and reliable.
Validation of the Santa Casa evaluation of spasticity scale
Arquivos de Neuro-Psiquiatria, 2010
Spasticity is a clinical condition that has negative repercussions on function. A scale capable of quantifying the severity and impact of an injury is fundamental to the rehabilitation process. The objective of this study was to retest and validate the Santa Casa evaluation of spasticity scale, a descriptive assessment of activities of daily living, transfers and locomotion. We analyzed spasticity and functional status in 97 hemiparetic patients. With statistical significance (p<0.05), this new scale demonstrated reliability in assessing clinical-functional conditions and reproducibility as a daily assessment scale for use during rehabilitation.
Robotic Assessment System for Spasticity in Patients with Acquired Brain Injury
2015
Nitin Seth Advisor: University of Guelph, 2015 Dr. Hussein A. Abdullah Spasticity is a symptom of upper motor neuron (UMN) syndrome that commonly affects individuals suffering the effects of stroke, multiple-sclerosis, spinal cord injury, or acquired brain injury. Current clinical standards and methods available for assessing and quantifying the effects of the UMN syndrome are considered to lack sensitivity and do not properly reflect the condition of the patient. This work discusses the analysis and quantification of spasticity in patients with acquired brain injury. A sensor integrated robotic system was developed in close consultations with physiotherapists to assist in the spasticity assessment and monitoring of individuals receiving care. Resistive force measurements have been obtained from individuals undergoing flexion and extension of the elbow joint in the sagittal plane. Repetitions were performed at progressively increasing speeds in an effort to capture the velocity depe...