Relationship between post-stroke spasticity and functional ambulation among Nigerian stroke survivors (original) (raw)
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Role of Spasticity Severity in the Balance of Post-stroke Patients
Frontiers in Human Neuroscience, 2021
Background: Lower limb spasticity after stroke is common that can affect the balance, increase the risk of falling, and reduces the quality of life.Objective: First, evaluate the effects of spasticity severity of ankle plantar flexors on balance of patients after stroke. Second, to determine the relationship between the spasticity severity with ankle proprioception, passive ankle dorsiflexion range of motion (ROM), and balance confidence.Methods: Twenty-eight patients with stroke based on the Modified Modified Ashworth Scale (MMAS) were divided into two groups: High Spasticity Group (HSG) (MMAS > 2) (n = 14) or a Low Spasticity Group (LSG) (MMAS ≤ 2) (n = 14). The MMAS scores, Activities-Specific Balance Confidence Questionnaire, postural sway of both affected and non-affected limbs under the eyes open and eyes closed conditions, timed up and go (TUG) test, passive ankle dorsiflexion ROM, and ankle joint proprioception were measured.Results: The ankle joint proprioception was sig...
International Journal of Physical Medicine & Rehabilitation, 2014
Background: Spasticity and muscle weakness are the primary impairments that result in activity limitation after stroke. Functional mobility is the ability to transfer independently from one place to another that depends on the extent of impairments affecting body function. The knowledge of relationship between the physical consequences of stroke and functional limitation helps therapist to implement the most effective rehabilitation approach to improve mobility.
Brain Injury, 2013
Primary objective: To evaluate the reliability of the Modified Tardieu Scale (MTS) in the measurement of ankle plantarflexor spasticity in patients after stroke. Research design: Inter-and intra-rater reliability study. Interventions: Not applicable. Methods and procedures: Adult patients after stroke participated. Patients were tested by two raters for inter-rater reliability. Patients were re-tested by one rater at least 1 week later for intra-rater reliability. The plantarflexors on the hemiparetic side were tested. Main outcomes and results: The ICCs of inter and intra-rater reliability across all components of MTS were moderate and moderately high (range 0.40-0.71). Inter-and intra-rater reliability for the dynamic component of spasticity (R2-R1) were moderate (ICC ¼ 0.57 and 0.40, respectively). The difference between the two raters for R2 was statistically significant (p ¼ 0.001). Conclusions: The reliability of the Modified Tardieu Scale in the measurement of ankle plantarflexor spasticity in adult patients after stroke was insufficient for routine use in clinical settings and research.
Indian Journal of Physiotherapy and Occupational Therapy—An International Journal, 2020
Background: Stroke is one of the most commonly occurring disease which leads to hemiparesis along with other symptoms like spasticity, sensory disturbances etc. considered to be a part of positive signs of upper motor neuron (UMN) syndrome. Spasticity is a common disorder in patients with injury of the brain and spinal cord. Aim: The aim of the present study was to corelate the foot posture index, H/M ratio and spatial gait parameters in the assessment of poststroke patients with ankle planter-flexor spasticity. Methodology: It was an observational study which consisted of 32 chronic stroke patients. Both male and female with age group 45-70 years and stroke duration more than 3 months were included in the study. Spasticity was assessed using H/M ratio, foot posture was assessed by Foot Posture Index (FPI) and Step length and Stride length were taken. Result: Statistical analysis was done using SPSS 20 for windows. The correlation between Hmax/Mmax ratio, FPI, step length and Stride...
Occurrence and Predictors of Spasticity after First-ever Stroke: A Systematic Review
Indian Journal of Physical Medicine and Rehabilitation, 2021
Aim and objective: To review recent studies on occurrence and predictors of post-stroke spasticity (PSS) after first-ever stroke. Materials and methods: A systematic search of online databases including PubMed, Elsevier, and Springer was performed for literature describing occurrences and predictors of PSS. These data were collected and analyzed. Results: Nine studies on prevalence including approximately 7,756 participants and 6 studies on predictors of PSS with approximately 755 patients were analyzed. The prevalence of PSS was 7-42% in a maximum 18-month post-stroke follow-up and increased muscle tone, greater severity of paresis, sensory impairment, and low Barthel Index score were predictors of PSS. Conclusion: Under 65 years of age, patients are more prone to developing PSS, mainly in upper limbs at one year. For the determination of PSS prevalence, multiple parameters of spasticity measurement with biomechanical factors are to be needed. Early advanced rehabilitation, with background knowledge of predictors of PSS, the functional ability can be improved to achieve better outcomes and quality of life.
https://www.ijhsr.org/IJHSR\_Vol.11\_Issue.8\_Aug2021/IJHSR-Abstract.015.html, 2021
Background: Spasticity is a common impairment following upper motor neuron lesions such as stroke. The appropriate measure of muscle spasticity, using validated tools to evaluate the outcome of therapies is important in clinical and research settings. Objective: To determine the concurrent criterion-related validity of the Modified Ashworth Scale in assessing post stroke Ankle flexor muscle spasticity based on its correlation with Modified Tardieu scale and the H-reflex tests. Methods: A total of 35 adult stroke participants underwent clinical and electrophysiological assessment of the ankle flexor muscle spasticity on the affected side. The primary outcome measures were: MMAS grade, R2−R1 of the MTS; and the H-reflex indices of H-max/M-max ratio. Results: Correlations tests revealed the correlation between the MMAS and MTS but did not reveal significant associations between the MMAS and the H-reflex tests. Conclusions: This study suggests that the MMAS may not be a valid tool to evaluate the ankle flexor muscle spasticity in these stroke participants.
Evaluation of upper-limb spasticity after stroke: A clinical and neurophysiologic study
Archives of Physical Medicine and Rehabilitation, 2005
Pizzi A, Carlucci G, Falsini C, Verdesca S, Grippo A. Evaluation of upper-limb spasticity after stroke: a clinical and neurophysiologic study. Arch Phys Med Rehabil 2005;86:410-5. Objectives: To assess upper-limb spasticity after stroke by means of clinical and instrumental tools and to identify possible variables influencing the clinical pattern. Design: Descriptive measurement study of a consecutive sample of patients with upper-limb spasticity after stroke. Setting: Neurorehabilitation hospital. Participants: Sixty-five poststroke hemiplegic patients. Interventions: Not applicable. Main Outcome Measures: Upper-limb spasticity, as assessed clinically (Modified Ashworth Scale [MAS], articular goniometry) and neurophysiologically (maximum H-reflex [Hmax], maximum M response [Mmax], Hmax/Mmax ratio).
Prevalence of Spasticity and Postural Patterns in the Upper Extremity Post Stroke
Journal of Stroke and Cerebrovascular Diseases, 2020
Introduction: A high number of patients with stroke develop upper extremity spasticity, causing abnormal postures and patterns. These alterations limit the use of arm in functional activities and affect social participation. Aim: To determine the prevalence of spasticity and postural patterns of the upper extremity post stroke. Materials and methods: A cross-sectional descriptive design was used with a prospective follow-up. The sample included 136 patients. The study included 3 measuring times; at 10 days (T1), applying a record with sociodemographic-clinical data, the evaluation of muscle tone in the elbow and wrist and the postural patterns of the UE, and at 3 months (T2) and 12 months (T3) post stroke, re-evaluating tone and patterns. Prevalence was calculated through the one-sample chi-squared (x2) test followed by inspection of the standardized residuals (z) in each cell. The Kappa coefficient evaluated the degree of agreement in elbow and wrist tone. Results: The prevalence of spasticity in the elbow was 37.5% at T1, 57.4% at T2, and 57.4% at T3. At each time there was a high degree of agreement between elbow and wrist tone. Patients developed increased elbow tone between T1 and T2, with maintained tone between T2 and T3. Postural pattern III was the most prevalent according to Hefter's classification. Conclusion: The prevalence of spasticity in the elbow and wrist increases between 10 days and 3 months post stroke, and is maintained between 3 and 12 months. The onset of spasticity occurs in almost half of patients during the first 10 days post stroke. Postural pattern III according to Hefter's classification presented the greatest prevalence in the spastic UE.
JMIR Research Protocols, 2020
Background The lower limb spasticity after stroke can affect the balance and gait of patients with stroke. Objective The aim of this study is to assess the effects of ankle plantar flexor spasticity level on balance in patients with stroke. Methods Patients with stroke were recruited from neurology and physiotherapy clinics in Tehran, Iran. Based on the level of ankle plantar flexor spasticity according to the Modified Modified Ashworth Scale (MMAS), the eligible patients with stroke were divided into 2 groups: high spasticity (MMAS score≥2) and low spasticity (MMAS score<2). The primary outcome measures were the MMAS scores, Activities-Specific Balance Confidence questionnaire scores, eyes-open and eyes-closed posturography measures, and Timed Up and Go test results. The secondary outcome measures were the ankle passive range of motion and ankle joint proprioception. The t test, mixed model univariate analysis of variance, and Spearman rank correlation were used for statistical ...
Biomechanical measurement of post-stroke spasticity
Age and Ageing, 2006
Background: spasticity following stroke is common, but clinical measurement is difficult and inaccurate. The most common measure is the modified Ashworth scale (MAS) which grades resistance to passive movement (RPM), but its validity is unclear. Aim: to assess the validity of the MAS. Methods: spasticity was clinically graded using MAS and RPM measured biomechanically in the impaired arm of 111 patients following stroke. The biomechanical device measured RPM, applied force, angular displacement, mean velocity, passive range of movement (PROM) and time required.