Skip Navigation



Age and Ageing Advance Access published online on May 4, 2006
Age and Ageing, doi:10.1093/ageing/afj084
This Article
Right arrow FREE Full Text (PDF) Freely available
Right arrow All Versions of this Article:
35/4/371    most recent
afj084v1
Right arrow E-letters: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Kumar, R. T. S.
Right arrow Articles by Sharma, A. K.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Kumar, R. T. S.
Right arrow Articles by Sharma, A. K.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© The Author 2006. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org
Received September 19, 2005
Accepted February 13, 2006

Article

Biomechanical measurement of post-stroke spasticity

Raj T. S. Kumar 1 *, Anand D. Pandyan 2, and Anil K. Sharma 1

1 Department of Medicine for the Elderly, University Hospital Aintree, Liverpool L9 7AL, UK
2 Department of Physiotherapy Studies, Keele University, Staffs ST5 5BG, UK

* To whom correspondence should be addressed.
Raj T. S. Kumar, E-mail: raj.kumar{at}aintree.nhs.uk


  Abstract

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.

Results: the median age was 72 years, and 66 subjects were male. The clinical grading by MAS was ‘0’ in 15, ‘1’ in 15, ‘1+’ in 14, ‘2’ in 13, ‘3’ in 43 and ‘4’ in 11. There was no difference in RPM among ‘0’, ‘1’, ‘1+’ and ‘2’ (P>0.1). However, grade‘4’ was higher than ‘3’ and below (P<0.05). The force required increased with the increasing MAS while velocity and PROM decreased (P<0.01). We regrouped the data using the algorithm: no stiffness = ‘0’; mild = ‘1’ and ‘1+’ and ‘2’; moderate = ‘3’; severe = ‘4’. There was no difference between ‘no stiffness’ and ‘mild ’ (P>0.10), but ‘mild’ and moderate’ as well as ‘moderate’ and ‘severe’ were different (P<0.01).

Conclusion: the MAS is not a valid ordinal level measure of RPM or spasticity. Objective measurement of RPM is possible in the clinical setting. However, additional measurements of muscle activity (electromyography) will be required to quantify spasticity.

Keywords: stroke, cerebrovascular accident, spasticity, measurement, elderly.
Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 ptjournalHome page
E. Cousins, A. B. Ward, C. Roffe, L. D. Rimington, and A. D. Pandyan
Quantitative Measurement of Poststroke Spasticity and Response to Treatment With Botulinum Toxin: A 2-Patient Case Report
Physical Therapy, July 1, 2009; 89(7): 688 - 697.
[Abstract] [Full Text] [PDF]


Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.