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Technical Briefs

A New Standard in Objective Measurement of Spasticity

[+] Author and Article Information
Mindy F. Levin, Aditi A. Mullick, Marcos Rodrigues

School of Physical and Occupational Therapy,
McGill University;
Center for Interdisciplinary Research in Rehabilitation,
Montreal, Quebec.

Anatol G. Feldman

Department of Physiology,
University of Montreal
, Montreal, Quebec. Canada;
Center for Interdisciplinary Research in Rehabilitation,
Montreal, Quebec.

Manuscript received March 15, 2013; final manuscript received April 26, 2013; published online July 3, 2013. Assoc. Editor: Arthur G. Erdman.

J. Med. Devices 7(3), 030909 (Jul 03, 2013) (2 pages) Paper No: MED-13-1047; doi: 10.1115/1.4024488 History: Received March 15, 2013; Revised April 26, 2013

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References

Burke, D., 1988, “Spasticity as an Adaptation to Pyramidal Tract Injury,” In: Waxman, S. G., editor, Advances in Neurology, Functional Recovery in Neurological Disease, New York: Raven Press, pp. 401–423.
Cans, C., 2000, “Surveillance of Cerebral Palsy in Europe: A Collaboration of Cerebral Palsy Surveys and Registers. Surveillance of Cerebral Palsy in Europe (SCPE),” Dev. Med. Child Neurol., 42(12), pp. 816–824.
Elovic, E. P., Simone, L. K., and Zafonte, R., 2004, “Outcome Assessment for Spasticity Management in the Patient With Traumatic Brain Injury: The State of the Art,” J. Head Trauma Rehabil., 19, pp. 155–177. [CrossRef] [PubMed]
Wood, D. E., Burridge, J. H., Van Wijck, F. M., et al. ., 2005, “Biomechanical Approaches Applied to the Lower and Upper Limb for the Measurement of Spasticity: A Systematic Review ofthe Literature,” Disabil. Rehab., 27(1–2), pp. 19–32. [CrossRef]
Lance, J. W., 1980, “Symposium Synopsis,” In: Feldman, R. G., Young, R. R. and Koella, W. P., editors. Spasticity: Disordered Motor Control. Chicago: Yearbook Medical Publishers, pp. 185–220.
Levin, M. F., and Feldman, A. G., 1994, “The Role of Stretch Reflex Threshold Regulation in Normal and Impaired Motor Control,” Brain Res., 657, pp. 23–30. [CrossRef] [PubMed]
Lindberg, P. G., Gaverth, J., Islam, M., et al. ., 2011, “Validation of a New Biomechanical Model to Meaure Muscle Tone in Spastic Muscle,” Neurorehabil. Neural. Rep., 25(7), pp. 617–625. [CrossRef]
Bohannon, R. W., and Smith, M. B., 1987, “Interrater Reliability of a Modified Ashworth Scale of Muscle Spasticity,” Phys. Ther., 67(2), pp. 206–207. [PubMed]
Calota, A., Feldman, A. G., and Levin, M. F., 2008, “Spasticity Measurement Based on Tonic Stretch Reflex Threshold in Stroke Using a Portable Device,” Clin. Neurophysiol., 119, pp. 2329–2337. [CrossRef] [PubMed]
MullickA. A., Musampa, N. K., Feldman, A. G., and Levin, M. F., in press, “Stretch Reflex Spatial Threshold Measure Discriminates Between Spasticity and Rigidity,” Clin. Neurophysiol.

Figures

Grahic Jump Location
Fig. 1

Schematic diagram of the TRS threshold measurement system as applied to measure spasticity in the elbow flexor muscles (biceps brachii)

Grahic Jump Location
Fig. 2

Data for one stretch trial in a patient with spasticity in the biceps muscle is shown. EMG signals are filtered and rectified (blue) and the angle (red trace) and velocity of stretch (green trace) at the onset of the EMG activity (thin vertical blue line) is identified. Values of threshold angle and velocity at each speed of stretch are computed and used to determine the tonic stretch reflex (TSR) threshold, a measure of spasticity.

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