TY - JOUR
T1 - Measuring resistance to externally induced movement of the wrist joint in chronic stroke patients using an objective hand-held dynamometer
AU - Mahmoud, Wala'
AU - Haugland, Morten
AU - Ramos-Murguialday, Ander
AU - Hultborn, Hans
AU - Ziemann, Ulf
N1 - Publisher Copyright:
© 2023 International Federation of Clinical Neurophysiology
PY - 2023/1
Y1 - 2023/1
N2 - Objective: We evaluated the resistance to externally induced wrist extension in chronic stroke patients. We aimed to objectively measure and distinguish passive (muscle and soft tissue stiffness) and active (spasticity and spastic dystonia) components of the resistance. Methods: We used a hand-held dynamometer, which measures torque, joint movement and electromyography (EMG) simultaneously, to assess the resistance to externally induced wrist extension. Slow and fast stretches were applied to the affected and unaffected wrists in 57 chronic stroke patients (57 ± 11 years). We extracted from the data parameters that represent passive and muscle activity components and assessed the validity, test–retest reliability and the clinical utility of the measurement. Results: The analysis showed (1) a significant difference in the passive and muscle activity components between the affected and unaffected sides; (2) a significant correlation between passive and muscle activity components and the modified Ashworth scale (MAS); (3) a significant difference between the subgroups of patients stratified by the MAS; (4) an excellent intra-rater reliability on each of the passive and muscle activity components with intra-class coefficients between 0.92 and 0.99; (5) and small measurement error. Conclusions: Using a hand-held dynamometer, we were able to objectively measure the resistance to muscle stretch in the wrist joint in chronic stroke patients and discriminate muscle overactivity components from muscle and soft tissue stiffness. We demonstrated validity, test–retest reliability and the clinical utility of the measurement. Significance: Quantification of the different components of resistance to externally induced movement enables the objective evaluation of neurorehabilitation effects in chronic stroke patients.
AB - Objective: We evaluated the resistance to externally induced wrist extension in chronic stroke patients. We aimed to objectively measure and distinguish passive (muscle and soft tissue stiffness) and active (spasticity and spastic dystonia) components of the resistance. Methods: We used a hand-held dynamometer, which measures torque, joint movement and electromyography (EMG) simultaneously, to assess the resistance to externally induced wrist extension. Slow and fast stretches were applied to the affected and unaffected wrists in 57 chronic stroke patients (57 ± 11 years). We extracted from the data parameters that represent passive and muscle activity components and assessed the validity, test–retest reliability and the clinical utility of the measurement. Results: The analysis showed (1) a significant difference in the passive and muscle activity components between the affected and unaffected sides; (2) a significant correlation between passive and muscle activity components and the modified Ashworth scale (MAS); (3) a significant difference between the subgroups of patients stratified by the MAS; (4) an excellent intra-rater reliability on each of the passive and muscle activity components with intra-class coefficients between 0.92 and 0.99; (5) and small measurement error. Conclusions: Using a hand-held dynamometer, we were able to objectively measure the resistance to muscle stretch in the wrist joint in chronic stroke patients and discriminate muscle overactivity components from muscle and soft tissue stiffness. We demonstrated validity, test–retest reliability and the clinical utility of the measurement. Significance: Quantification of the different components of resistance to externally induced movement enables the objective evaluation of neurorehabilitation effects in chronic stroke patients.
KW - Muscle stiffness
KW - Spastic stroke
KW - Spasticity
KW - Spasticity measurement
UR - http://www.scopus.com/inward/record.url?scp=85160577797&partnerID=8YFLogxK
U2 - 10.1016/j.cnp.2023.05.001
DO - 10.1016/j.cnp.2023.05.001
M3 - Article
AN - SCOPUS:85160577797
SN - 2467-981X
VL - 8
SP - 97
EP - 110
JO - Clinical Neurophysiology Practice
JF - Clinical Neurophysiology Practice
ER -