Article

Most clinical tools for measuring spasticity, such as the Modified Ashworth Scale
(MAS) and the Modified Tardieu Scale (MTS), are not sufficiently accurate or
reliable. This study investigated the clinimetric properties of an instrumented
spasticity assessment. Twenty-eight children with spastic cerebral palsy (CP) and
10 typically developing (TD) children were included. Six of the children with CP
were retested to evaluate reliability. To quantify spasticity in the
gastrocnemius (GAS) and medial hamstrings (MEH), three synchronized signals were
collected and integrated: surface electromyography (sEMG); joint-angle
characteristics; and torque. Muscles were manually stretched at low velocity (LV)
and high velocity (HV). Spasticity parameters were extracted from the change in
sEMG and in torque between LV and HV. Reliability was determined with
intraclass-correlation coefficients and the standard error of measurement;
validity by assessing group differences and correlating spasticity parameters
with the MAS and MTS. Reliability was moderately high for both muscles.
Spasticity parameters in both muscles were higher in children with CP than in TD
children, showed moderate correlation with the MAS for both muscles and good
correlation to the MTS for the MEH. Spasticity assessment based on
multidimensional signals therefore provides reliable and clinically relevant
measures of spasticity. Moreover, the moderate correlations of the MAS and MTS
with the objective parameters further stress the added value of the instrumented
measurements to detect and investigate spasticity, especially for the GAS.
CI - Copyright (c) 2012 Elsevier B.V. All rights reserved.

Langue : ANGLAIS