Biomechanical measurement of post-stroke spasticity
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: spast...
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| Veröffentlicht in: | Age and ageing 2006-07, Vol.35 (4), p.371-375 |
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| creator | Kumar, Raj T. S. Pandyan, Anand D. Sharma, Anil K. |
| description | 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 |
| doi_str_mv | 10.1093/ageing/afj084 |
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S. ; Pandyan, Anand D. ; Sharma, Anil K.</creator><creatorcontrib>Kumar, Raj T. S. ; Pandyan, Anand D. ; Sharma, Anil K.</creatorcontrib><description>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.</description><identifier>ISSN: 0002-0729</identifier><identifier>EISSN: 1468-2834</identifier><identifier>DOI: 10.1093/ageing/afj084</identifier><identifier>PMID: 16675479</identifier><identifier>CODEN: AANGAH</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>Aged ; Biomechanical Phenomena ; Care and treatment ; cerebrovascular accident ; Cross-Sectional Studies ; elderly ; Female ; Health aspects ; Health care ; Humans ; Male ; measurement ; Measurement techniques ; Middle Aged ; Movement ; Muscle Spasticity - diagnosis ; Muscle Spasticity - etiology ; Muscle Spasticity - physiopathology ; Older people ; Range of Motion, Articular ; Reproducibility of Results ; Spasticity ; Stroke ; Stroke (Disease) ; Stroke - classification ; Stroke - complications ; Validation studies</subject><ispartof>Age and ageing, 2006-07, Vol.35 (4), p.371-375</ispartof><rights>Copyright Oxford University Press(England) Jul 2006</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c499t-70c95764564cec9cfaa7acfb0b5ce4d9f3a365a08889ca9cb219be7dc883953b3</citedby><cites>FETCH-LOGICAL-c499t-70c95764564cec9cfaa7acfb0b5ce4d9f3a365a08889ca9cb219be7dc883953b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902,30976</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16675479$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kumar, Raj T. S.</creatorcontrib><creatorcontrib>Pandyan, Anand D.</creatorcontrib><creatorcontrib>Sharma, Anil K.</creatorcontrib><title>Biomechanical measurement of post-stroke spasticity</title><title>Age and ageing</title><addtitle>Age Ageing</addtitle><description>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.</description><subject>Aged</subject><subject>Biomechanical Phenomena</subject><subject>Care and treatment</subject><subject>cerebrovascular accident</subject><subject>Cross-Sectional Studies</subject><subject>elderly</subject><subject>Female</subject><subject>Health aspects</subject><subject>Health care</subject><subject>Humans</subject><subject>Male</subject><subject>measurement</subject><subject>Measurement techniques</subject><subject>Middle Aged</subject><subject>Movement</subject><subject>Muscle Spasticity - diagnosis</subject><subject>Muscle Spasticity - etiology</subject><subject>Muscle Spasticity - physiopathology</subject><subject>Older people</subject><subject>Range of Motion, Articular</subject><subject>Reproducibility of Results</subject><subject>Spasticity</subject><subject>Stroke</subject><subject>Stroke (Disease)</subject><subject>Stroke - classification</subject><subject>Stroke - complications</subject><subject>Validation studies</subject><issn>0002-0729</issn><issn>1468-2834</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><recordid>eNpdkE1rGzEQhkVpadykx1yD6SG3bfS5ko6paZpCSnLIF70I7XjWlbO7ciUtNP--G2xiyGkY5uGdl4eQY0a_MmrFmV9hGFZnvl1TI9-RGZO1qbgR8j2ZUUp5RTW3B-RTzutpZYrxj-SA1bVWUtsZEd9C7BH--CGA7-Y9-jwm7HEo89jONzGXKpcUn3CeNz6XAKE8H5EPre8yft7NQ3J38f12cVldXf_4uTi_qkBaWypNwSpdS1VLQLDQeq89tA1tFKBc2lZ4UStPjTEWvIWGM9ugXoIxwirRiENyus3dpPh3xFxcHzJg1_kB45hdbRjlXNEJ_PIGXMcxDVM3x5lkQhmuJ6jaQivfoQsDxKHgvwKx63CFbmq-uHbnTFqmtFVyz0OKOSds3SaF3qdnx6h7Ue-26t1W_cSf7EqMTY_LPb1zvQ8MeXr8evfpydVaaOUuH387Yc3D_c39L3cr_gPRLI9w</recordid><startdate>20060701</startdate><enddate>20060701</enddate><creator>Kumar, Raj T. S.</creator><creator>Pandyan, Anand D.</creator><creator>Sharma, Anil K.</creator><general>Oxford University Press</general><general>Oxford Publishing Limited (England)</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QJ</scope><scope>7T5</scope><scope>7TK</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>20060701</creationdate><title>Biomechanical measurement of post-stroke spasticity</title><author>Kumar, Raj T. S. ; Pandyan, Anand D. ; Sharma, Anil K.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c499t-70c95764564cec9cfaa7acfb0b5ce4d9f3a365a08889ca9cb219be7dc883953b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2006</creationdate><topic>Aged</topic><topic>Biomechanical Phenomena</topic><topic>Care and treatment</topic><topic>cerebrovascular accident</topic><topic>Cross-Sectional Studies</topic><topic>elderly</topic><topic>Female</topic><topic>Health aspects</topic><topic>Health care</topic><topic>Humans</topic><topic>Male</topic><topic>measurement</topic><topic>Measurement techniques</topic><topic>Middle Aged</topic><topic>Movement</topic><topic>Muscle Spasticity - diagnosis</topic><topic>Muscle Spasticity - etiology</topic><topic>Muscle Spasticity - physiopathology</topic><topic>Older people</topic><topic>Range of Motion, Articular</topic><topic>Reproducibility of Results</topic><topic>Spasticity</topic><topic>Stroke</topic><topic>Stroke (Disease)</topic><topic>Stroke - classification</topic><topic>Stroke - complications</topic><topic>Validation studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kumar, Raj T. S.</creatorcontrib><creatorcontrib>Pandyan, Anand D.</creatorcontrib><creatorcontrib>Sharma, Anil K.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Age and ageing</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kumar, Raj T. S.</au><au>Pandyan, Anand D.</au><au>Sharma, Anil K.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Biomechanical measurement of post-stroke spasticity</atitle><jtitle>Age and ageing</jtitle><addtitle>Age Ageing</addtitle><date>2006-07-01</date><risdate>2006</risdate><volume>35</volume><issue>4</issue><spage>371</spage><epage>375</epage><pages>371-375</pages><issn>0002-0729</issn><eissn>1468-2834</eissn><coden>AANGAH</coden><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.</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>16675479</pmid><doi>10.1093/ageing/afj084</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Biomechanical Phenomena Care and treatment cerebrovascular accident Cross-Sectional Studies elderly Female Health aspects Health care Humans Male measurement Measurement techniques Middle Aged Movement Muscle Spasticity - diagnosis Muscle Spasticity - etiology Muscle Spasticity - physiopathology Older people Range of Motion, Articular Reproducibility of Results Spasticity Stroke Stroke (Disease) Stroke - classification Stroke - complications Validation studies |
| title | Biomechanical measurement of post-stroke spasticity |
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