Journal ArticleDOI
A review of the properties and limitations of the Ashworth and modified Ashworth Scales as measures of spasticity
Anand Pandyan,Garth R. Johnson,Christopher Price,Richard Curless,Michael P. Barnes,Helen Rodgers +5 more
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TLDR
The application of both scales would suggest that confusion exists on their characteristics and limitations as measures of spasticity, and there is a need to standardize methods to apply these scales in clinical practice and research.Abstract:
Background: The Ashworth Scale and the modified Ashworth Scale are the primary clinical measures of spasticity. A prerequisite for using any scale is a knowledge of its characteristics and limitations, as these will play a part in analysing and interpreting the data. Despite the current emphasis on treating spasticity, clinicians rarely measure it.Objectives: To determine the validity and the reliability of the Ashworth and modified Ashworth Scales.Study design: A theoretical analysis following a structured literature review (key words: Ashworth; Spasticity; Measurement) of 40 papers selected from the BIDS-EMBASE, First Search and Medline databases.Conclusions: The application of both scales would suggest that confusion exists on their characteristics and limitations as measures of spasticity. Resistance to passive movement is a complex measure that will be influenced by many factors, only one of which could be spasticity. The Ashworth Scale (AS) can be used as an ordinal level measure of resistance to pa...read more
Citations
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Journal ArticleDOI
Validity and reliability of the Serbian version of Patient-Reported Impact of Spasticity Measure in multiple sclerosis.
Tatjana Knezevic,Ljubica Konstantinovic,Sindi Z. Rodic,Calogero Foti,Jelena Drulovic,Jelena Dackovic,Dejan Nikolic,Ivana Petronic,Dobrivoje S. Stokic +8 more
TL;DR: PRISMSR shows adequate validity and reliability for assessing the impact of spasticity on quality of life in patients with MS and may be translated successfully into other languages.
Journal ArticleDOI
A review of the effects of baclofen and of THC:CBD oromucosal spray on spasticity-related walking impairment in multiple sclerosis.
TL;DR: Introduction: Multiple sclerosis is a complex disease with a heterogeneous and unpredictable clinical course.
Journal ArticleDOI
Clinical evaluation of hypertonia in the triceps surae muscles.
TL;DR: Serial evaluation of passive range of motion and muscle stiffness in patients with hypertonia provides useful information for treatment planning and there is a need to consider methods of monitoring changes in muscle stiffness following brain injury.
Journal ArticleDOI
Design and Clinical Validation of a Robotic Ankle-Foot Simulator With Series Elastic Actuator for Ankle Clonus Assessment Training
Yinan Pei,Tianyi Han,Christopher M. Zallek,Tao Liu,Liangjing Yang,Elizabeth T. Hsiao-Wecksler +5 more
Abstract: To fulfill the need for reliable and consistent medical training of the neurological examination technique to assess ankle clonus, a series elastic actuator (SEA) based haptic training simulator was proposed and developed. The simulator's mechanism (a hybrid of belt and linkage drive) and controller (impedance control) were designed to render a realistic and safe training environment. Benchtop tests demonstrated that the prototype simulator was able to accurately estimate the interaction torque from the trainee (average RMSE of 0.2 Nm) and closely track a chirp torque command up to 10 Hz (average RMSE of <0.22 Nm). The high-level impedance controller could switch between different clinically encountered states (i.e., no clonus, unsustained clonus, and sustained clonus) based on trainee's assessment technique. The simulator was evaluated by a group of 17 experienced physicians and physical therapists. Subjects were instructed to induce sustained clonus using their normal technique. The simulator was assessed in two common clinical positions (seated and supine). Subjects scored simulation realism on a variety of control features. To expedite controller design iteration, feedback from Day 1 was used to modify simulation parameters prior to testing on Day 2 with a new subject group. On average, all subjects could successfully trigger a sustained clonus response within 4-5 attempts in the first position and 2-3 in the second. Feedback on the fidelity of simulation realism improved between Day 1 and Day 2. Results suggest that this SEA-based simulator could be a viable training tool for healthcare trainees learning to assess ankle clonus.
Journal ArticleDOI
Neuroimaging assessment of spasticity developed after acquired brain injuries and multiple sclerosis.
M.A. Bertoni,M.A. Bertoni,M. Sakel,A. Hojjattoleslami,I.V. Bertoni,Nagulan Ratnarajah,Nagulan Ratnarajah +6 more
TL;DR: Findings suggest that NPDSa and discharge and RCSd are higher in those developing spasticity, and subjects with MS are more likely to developSpasticity especially if the lesions are numerous and affect the corticospinal tracts, callosal radiations extensively or brainstem.
References
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Book
Nonparametric statistics for the behavioral sciences
TL;DR: This is the revision of the classic text in the field, adding two new chapters and thoroughly updating all others as discussed by the authors, and the original structure is retained, and the book continues to serve as a combined text/reference.
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An introduction to categorical data analysis
TL;DR: In this paper, the authors present a tour of categorical data analysis for Contingency Tables and Logit and Loglinear models for contingency tables, as well as generalized linear models for Matched Pairs.
Journal ArticleDOI
Interrater Reliability of a Modified Ashworth Scale of Muscle Spasticity
TL;DR: The relationship between the raters' judgments was significant and the reliability was good, and it is believed these results to be positive enough to encourage further trials of the modified Ashworth scale for grading spasticity.
Book
An Introduction to Medical Statistics
TL;DR: The design of experiments, analysis of the means of small samples using the t-c Distribution, and selection of the statistical method for clinical measurement and the structure of human populations are reviewed.
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Introduction to multivariate analysis
TL;DR: In this article, the multivariate normal distribution is used for principal component analysis and multivariate analysis of covariance and related topics, as well as multi-dimensional scaling and cluster analysis.