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Spasticity After Stroke Its Occurrence and Association With Motor Impairments and Activity Limitations

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TLDR
Findings indicate that the focus on spasticity in stroke rehabilitation is out of step with its clinical importance, and careful and continual evaluation to establish the cause of the patient’s disabilities is essential before a decision is made on the most proper rehabilitation approach.
Abstract
Background and Purpose— There is no consensus concerning the number of patients developing spasticity or the relationship between spasticity and disabilities after acute stroke. The aim of the present study was to describe the extent to which spasticity occurs and is associated with disabilities (motor impairments and activity limitations). Methods— Ninety-five patients with first-ever stroke were examined initially (mean, 5.4 days) and 3 months after stroke with the Modified Ashworth Scale for spasticity; self-reported muscle stiffness; tendon reflexes; Birgitta Lindmark motor performance; Nine Hole Peg Test for manual dexterity; Rivermead Mobility Index; Get-Up and Go test; and Barthel Index. Results— Of the 95 patients studied, 64 were hemiparetic, 18 were spastic, 6 reported muscle stiffness, and 18 had increased tendon reflexes 3 months after stroke. Patients who were nonspastic (n=77) had statistically significantly better motor and activity scores than spastic patients (n=18). However, the correlat...

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Journal ArticleDOI

Rehabilitation after Stroke

TL;DR: A 66-year-old man was suddenly unable to speak, follow directions, or move his right arm and leg within 90 minutes and his speech was limited to effortful answers of yes or no.
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Strategies for stroke rehabilitation

TL;DR: Clinicians should encourage patients to build greater strength, speed, endurance, and precision of multijoint movements on tasks that increase independence and enrich daily activity to augment rehabilitation in the next decade.
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Rehabilitation of Motor Function after Stroke: A Multiple Systematic Review Focused on Techniques to Stimulate Upper Extremity Recovery.

TL;DR: This multiple systematic review focuses both on standard treatment methods and on innovating rehabilitation techniques used to promote upper extremity motor function in stroke patients to achieve the maximal motor function recovery for each patient.
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Pathophysiology of spastic paresis. I: Paresis and soft tissue changes.

TL;DR: The pathophysiology of the first two factors causing motor impairment in spastic paresis are focused on: the vicious cycle of paringis–disuse–paresis and the contracture in soft tissues.
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The spinal pathophysiology of spasticity--from a basic science point of view.

TL;DR: This review describes changes in cellular properties and transmission in a number of spinal reflex pathways, which may explain the increased stretch reflex excitability.
References
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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.
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The Barthel ADL Index: a reliability study*

TL;DR: Analysis of total (summed) scores revealed a close correlation between all four methods: a difference of 4/20 points was likely to reflect a genuine difference, and in individual items, most disagreement was minor and involved the definition of middle grades.
Journal Article

Balance in elderly patients : The "get-up and go" test

TL;DR: The get-up and go test proved to be a satisfactory clinical measure of balance in elderly people and had good correlation with laboratory tests.
Journal ArticleDOI

The Barthel ADL Index: A standard measure of physical disability?

TL;DR: It is argued that acceptance of a single standard measure of activities of daily living (ADL) might increase awareness of disability, improve clinical management of disabled patients, and might even increase acceptance of published research.
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