• Journal of the Korean Society of Physical Medicine
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• v.8 no.2
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• pp.209-217
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• 2013

PURPOSE: The purpose of this study was to investigate the clinical availability of the pendulum test (through reliability and validity) using a NK table attached electrogoniometer for spasticity measurement in patients with brain lesions. METHODS: Thirty-one stroke and traumatic brain injury subjects participated in the study. Intraclass correlation coefficient (ICC) was used to verify the test-retest reliability of spasticity measures of the pendulum test. Pearson's product correlation coefficient was used to examine the validity of the pendulum test through the amplitude of the deep tendon reflex (DTR) test known for objective and quantitative measure of spasticity. RESULTS: In these results, the test-retest reliability was showed significantly high correlation between pendulum tests (ICCs=.95~.97, p<.01). There were significant negative correlations between the amplitude of the DTR test and all measures of spasticity of the pendulum test(r=-.77~-.85, p<.01). CONCLUSION: Thus, it is possible to use the pendulum test using a NK table as an objective measure of spasticity, rather than other expensive equipment, which is more complicated to use. Further studies are needed to explore the therapeutic effects of spasticity using a newly designed pendulum test equipment in this study.

• Physical Therapy Korea
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• v.14 no.4
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• pp.7-13
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• 2007

The purpose of this study was to investigate correlations among objective measurements of spasticity in patients with brain lesions. Thirty-two stroke and traumatic brain injury subjects participated in the study. Spasticity was quantified using the knee first flexion angle, relaxation index obtained from a pendulum drop test, and the amplitude of a knee tendon reflex test. Pearson's product correlation coefficient was used to examine relationships among these measurements of spasticity. There was a significant positive correlation between the relaxation index and knee first flexion angle in patients with brain lesions (r=.895, p<.01). There was also significant negative correlation between the amplitude of knee tendon reflex and relaxation index (r=-.612, p<.01), and between amplitude and knee first flexion angle (r=-.537, p<.01). Thus, it is possible to use the knee first flexion angle as an objective measure of spasticity, rather than relaxation index, which is more complicated to obtain. Further studies are needed to explore the effects of functional improvement and long-lasting carryover effects of spasticity using a simple objective measure such as the knee first flexion angle from a pendulum test.

• Proceedings of the KSME Conference
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• 2000.04a
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• pp.268-273
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• 2000

Velocity-dependent increase in tonic stretch reflexes is one of the prominent characteristics of spasticity. It is very important to evaluate spasticity objectively and quantitatively before and after treatment for physicians. An accurate quantitative biomechanical evaluation for the spasticity which is caused by the disorder of central nervous system is made in this study. A sudden leg dropper which is designed to generate objective testing environment at every trial gives very effective environment for the test. Kinematic data are archived by the 3-dimensional motion analysis system($Elite^{(R)}$, B.T.S., Italy). Kinematic data are angle and angular velocity of lower limb joints, and length and lengthening velocity of lower limb muscle. A program is also developed to analyze the kinematic data of lower limb, contraction and relaxation length of muscles, and dynamic EMG data at the same tim. To evaluate spasticity quantitatively, total 31 parameters extracted from goniogram, EMG and muscle model are analyzed. Statistical analysis are made for bilateral correlations for all parameters. The described instrumentation and parameters to make quantitative and objective evaluation of spasticity shows good results.

• Journal of Acupuncture Research
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• v.27 no.4
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• pp.115-125
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• 2010

Objectives : The purpose of this study is to determine the effect of Bee-venom Acupuncture on upper limb spasticity control in stroke patients. Methods : Ten stroke patients with upper limb spasticity were randomly divided into two groups, a Bee-Venom Acupuncture group(group I) and a normal saline group(group II). After 1 week resting phase, this trial was used a cross-over trial. The numbers of Pharmacopuncture treatment were 3 times a week for 3 weeks. Modified Ashworth Scale(MAS), WMFT(Wolf Motor Function Test), The 10-second Test were used for evaluation of spasticity control before experiment, after 1 week, 2 weeks, 3 weeks. Results : Group I showed significant improvement(p<.05) in MAS, WMFT, The 10-second Test. But Group II showed no significant improvement(p<.05) in MAS, WMFT, The 10-second Test. The results showed significant difference in WMFT, The 10-second Test, but no significant difference in MAS between two groups. Conclusions : These results showed that Bee-venom Acupuncture might decrease upper limb spasticity and increase arm motor function in stroke patients. Further studies will be required to examine more cases in the long period for the effect on upper limb in spasticity by Bee-Venom Acupuncture.

• Journal of muscle and joint health
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• v.25 no.3
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• pp.167-175
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• 2018

Purpose: The aim of this study was to test the effects of passive exercise on upper extremities muscle spasticity, finger edema, and depression for chronic stroke patients. Methods: A non-equivalent pretest-posttest design was employed for this study. The subjects were 30 elderly patients who were hospitalized to treat chronic stroke. 15 patients were assigned to the experimental and control groups respectively. Passive exercise for 20 minutes per day, five days a week for 8 weeks (total 40 times) was provided for the experimental group. Outcome measurements included manual spasticity test to measure upper extremities' muscle spasticity, the ring measurement method for finger edema and the Korean version of Short-form Geriatric Depression Scale (SGDS-K) for depression. Results: The upper extremities' muscle spasticity (Z=-2.52 p=.012) and the degree of depression (F=5.56, p=.006) in the experimental group were significantly reduced compared to those of the control group. But the degree of finger edema did not significantly differ between the two groups (F=1.46, p=.240). Conclusion: Passive exercise for upper extremities should be encouraged for elderly patients with chronic stroke to enhance the upper extremities' functional capacity as well as depression.

• The Transactions of The Korean Institute of Electrical Engineers
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• v.58 no.6
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• pp.1180-1185
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• 2009

Spasticity is a velocity-dependent stretch reflex disorder of the body motor system developing after the injury of the central nervous system, in which certain muscles are continuously contracted involuntarily. Conventional methods such as the modified Ashworth scale, Spasm frequency scale, pendulum test and isokinetic dynamometer had some disadvantages: limitation in discriminating the increase of resistance, immovable and expensive device, not enough study parameters. Therefore, it is necessary to introduce clinically more useful instrument, which can produce objective data and are more convenient on spasticity measurement. Spasticity measuring methods were reviewed and a new measuring instrument was designed and introduced. The new measuring system is a portable spasticity-measurement system, which encompass various scopes of spasticity-related human signals such as electrophysiologic, kinematic and biomechanical data. Our device was designed in order to measure the joint angle, angular velocity, electromyographic signals and force. We suggest that this new system can diagnose the spasticity of the muscles, objectively.

• The Journal of Korean Physical Therapy
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• v.31 no.5
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• pp.311-316
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• 2019

Purpose: Generally, patients with stroke present with decreased balance and increased spasticity following weakness of the paralyzed muscles. Muscle weakness caused by stroke has two causes. This is caused by a decrease in motor output and an adaptive muscle change, resulting in muscle weakness and muscle paralysis. The purpose of this study was to investigate the effect of strengthening exercise on balance and spasticity in chronic stroke patients and to suggest the basis of clinical treatment. Methods: Twenty subjects were divided into two groups: a lower-extremity strengthening group (experimental group) and a general physical therapy group (control group). The sliding stander equipment was used for the experimental group and a regimen of warm-up exercise, the main exercise routine, and cool-down exercise were used for the muscle strengthening exercise program. Balance and spasticity were measured before and after the training period. Balance ability was measured by the Berg balance scale, the Timed up and Go test and the weight distribution of the paralyzed muscles by the Spacebalance 3D. Spasticity was measured by the Biodex system. Results: After the training periods, the experimental group showed a significant improvement in BBS, weight distribution of the paralyzed muscles, and decreased spasticity when compared to the control group (p<0.05). Conclusion: This study supported the hypothesis that lower-extremity strengthening exercise improves the balance and decreases the spasticity of stroke patients. If it is combined with conventional neurologic physiotherapy, it would be effective rehabilitation for stroke patients.

• Physical Therapy Rehabilitation Science
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• v.11 no.3
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• pp.344-349
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• 2022

Objective: The purpose of the present study was to determine whether sit to stand training combined with ultrasound improves the spasticity, muscle strength and gait speed in stroke patients Design: Randomized controlled study Methods: The current study included 40 stroke patients, who were randomly divided into two groups: the sit to stand training with ultrasound (USTS) group (n=20) and the sit to stand training (STS) group (n=20). All the participants underwent 30 sessions of STS training (thirty minutes, five days per week for six weeks). Additionally, the USTS group received ultrasound therapy. The present study evaluated the spasticity of ankle plantar-flexors by the composite spasticity score. The muscle strength and gait speed were evaluated using the handheld dynamometer and the 10-meter walk test, respectively. Results: The USTS group and the STS group showed significant improvements in spasticity, muscle strength and gait speed after the intervention (p<0.05). Significant improvement in the spasticity, muscle strength, and gait speed were observed in the USTS group compared to the control group (p < 0.05). Conclusions: The results of the current study imply that sit to stand training combined with ultrasound is a beneficial and effective therapeutic modality that can be employed to improve the spasticity, muscle strength and gait speed in stroke patients.

• Journal of the Korean Society of Physical Medicine
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• v.9 no.4
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• pp.447-454
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• 2014

PURPOSE: The aim of this study was to determine the effect of inclination treadmill training with dynamic stretching on the spasticity and gait of chronic stroke patients. METHODS: Twenty two subjects were randomly assigned to either an experimental group (EG, n=11) or a control group (CG, n=11). Both groups participated in a standard rehabilitation program; in addition, the EG participated in inclination treadmill training for 20 min per day, five times per week, for 4 weeks, and the CG participated in treadmill walking training for 20 min per day, five times per week, for 4 weeks. Outcome measurements, recorded before and post intervention. Walking ability was measured using the 10m walking test (10MWT) and Timed up and go (TUG) test. Spasticity of the medialis gastrocnemius was measured using a myotonometer. RESULTS: Significant differences were observed the both groups for walking ability and spasticity after the training program. The results of the study were follows: 10MWT and TUG was significantly increased in both groups (p<0.05) and it was also found to be significant between groups after intervention (p<0.05). Spasticity was significantly increased in both groups (p<0.05) and it was also found to be significant between the groups after intervention (p<0.05). CONCLUSION: These findings indicate that inclination treadmill training improves gait ability and reduces spasticity of the medialis gastrocnemius. Inclination treadmill training may be used as an easy, effective and accessible way to improve the walking ability and decrease spasticity in stroke patients. Further studies are necessary to generalize the findings of this study.

• The Korean Journal of Pain
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• v.9 no.1
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• pp.232-234
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• 1996

For surgical Treatment of spastic deformities of the foot, selective peripheral neurotomies were introduced. These neurotomies utilize microsurgical techniques and intraoperative electrical stimulation for better identification of the function of the fascicles constituting the nerve. Selectivity is required to supress the excess of spasticity without excessive weakening of motor strength and without producing exaggerated amyotrophy. To achieve this goal, minimum one fourth of the motor fibers must be preserved. Neurotomies may be indicated when spasticity is localized to muscle or muscle groups supplied by a single or a few peripheral nerves that are easily accessible. To help the surgeon decide if neurotomy is appropriate, temporary local anesthetic block of the nerve with bupivacaine can be useful. Such a test can determine if articular limitations result from spasticity, musculotendinous contractures, or articular ankyloses because only spasticity is decreased by the test. In additon, these tests give the patient a chance to appreciate what to expect from the operation.