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Cited by 314Botulinum Toxin and Related Neurological DisordersStroke Rehabilitation and RecoveryCerebral Palsy and Movement Disorders

Objective quantification of spastic hypertonia: Correlation with clinical findings

Katz, Richard T., Rovai, Gayle P., Brait, Cathy, Rymer, W.Zev·1992·Archives of Physical Medicine and Rehabilitation
DOI 10.1016/0003-9993(92)90007-j
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Abstract

To develop a reliable and objective technique for quantifying spastic hypertonia, ten chronically hemiplegic patients with varying degrees of spasticity were studied on three occasions during several weeks. The modified Ashworth scale, a clinical assessment of extremity tone, was performed before and after each of the following objective tests: (1) torque and EMG measurements during ramp and hold angular displacement about the elbow, (2) pendulum test of the lower extremity, and (3) H/M ratio studies of upper and lower extremities. Subject motor function was also quantified using the Fugl-Meyer motor assessment scale. A regression analysis was performed to determine how successfully each of the objective measures correlated with the clinical yardstick, the modified Ashworth scale. A similar correlation between the objective measures and the Fugl-Meyer motor assessment scale was performed. Temporal reproducibility of a test for a given subject was evaluated by performing an ANOVA of repeated measures for each test over the three study sessions in a given subject. We conclude that (1) both the ramp and hold threshold measurements and pendulum test offer acceptable objective measures of spastic hypertonia since they correlate closely with clinical perception, (2) the Fugl-Meyer motor assessment scale also correlates closely with the severity of spastic tone, and (3) objective measures of spastic hypertonia are often surprisingly reproducible when repeatedly applied to a selected group of chronic hemiplegic patients with long-standing spasticity.

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Authors
Katz, R. T., Rovai, G. P., Brait, C., & Rymer, W. Z.
Affiliations
  • Northwestern University (US)
  • Shirley Ryan AbilityLab (US)
ORCID
Rymer, W.Zev
Venue
Archives of Physical Medicine and Rehabilitation
Publisher
Elsevier BV
Published
1992-04
Volume
73
Issue
4
Pages
339-347
ISSN
0003-9993 (ISSN-L)
DOI
10.1016/0003-9993(92)90007-j
OpenAlex
W2046272835
Cited by
314
References
39
Citations by year
2026: 2 · 2025: 8 · 2024: 7 · 2023: 6 · 2022: 8 · 2021: 13 · 2020: 5 · 2019: 7 · 2018: 12 · 2017: 11 · 2016: 6 · 2015: 6 · 2014: 9 · 2013: 16 · 2012: 8
FWCI
4.55
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Archives of Physical Medicine and Rehabilitation (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health (5r01ns019331-14)
  • National Institute of Neurological Disorders and Stroke (NS-19331)
Topics
  • Health Sciences › Medicine › Neurology › Botulinum Toxin and Related Neurological Disorders
  • Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
  • Health Sciences › Medicine › Psychiatry and Mental health › Cerebral Palsy and Movement Disorders
Keywords
spastic hypertonia, spasticity, objective quantification, Modified Ashworth Scale, hemiplegia, elbow torque, electromyography, pendulum test, H/M ratio, motor function, test reproducibility
MeSH terms
Adult, Aged, Analysis of Variance, Electromyography, H-Reflex, Hemiplegia, Humans, Middle Aged, Motor Skills, Muscle Hypertonia, Muscle Spasticity, Muscle Tonus, Regression Analysis

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