Article

Spasticity (hypertonicity) is a frequent problem that can develop after stroke and can lead to a number of secondary complications, such as contractures and pain. Consequently, many rehabilitation resources are used in
treating the condition and its secondary complications.
At present, the clinical assessment of spasticity incorporates descriptive scales of resistance to passive
movement, but the use of a neurophysiological measure of muscle activity levels
has been advocated. This case report focuses on the diagnosis of spasticity
through the use of a neurophysiological measure.
CASE DESCRIPTION: . Two
individuals who required botulinum toxin treatment for poststroke spasticity were
assessed over a course of 20 weeks with both clinical (Modified Ashworth Scale)
and neurophysiological (surface electromyography recording of levels of muscle
activity) measures of spasticity. Additionally, arm function, arm movement, and
pain were measured. The individuals' responses to treatment with botulinum toxin
and overall recovery after stroke are described. OUTCOMES: There were
discrepancies between the clinical and the neurophysiological measures of
spasticity. The clinical measure of spasticity was not effective in consistently
identifying the presence of spasticity and, therefore, also was ineffective in documenting the individuals' responses to treatment.
The neurophysiological
measure was able to identify when muscle activity levels had been reduced, but a
reduction in muscle activity levels did not always correspond with a reduction in
Modified Ashworth Scale scores. DISCUSSION: The accurate identification of
spasticity is important not only for assessment but also for the selection of appropriate treatments after stroke.

Langue : ANGLAIS