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Mechanisms of Spasticity and Current Evaluation Methods

Yıl 2025, Cilt: 6 Sayı: 1, 9 - 22, 30.04.2025
https://doi.org/10.58208/cphs.1505389

Öz

Spasticity, characterized by increased muscle tone and exaggerated reflexes, is a common clinical
manifestation in various neurological conditions, including stroke, cerebral palsy, and multiple
sclerosis. A precise and thorough evaluation of spasticity is critical for effective treatment planning
and accurate prognosis monitoring. This article seeks to investigate the complex mechanisms
underlying spasticity and offers a comprehensive analysis of contemporary methods used in its
assessment. By deepening their understanding of the mechanisms driving spasticity and utilizing
innovative diagnostic tools, healthcare professionals can contribute to the advancement of treatment
strategies and improve outcomes for individuals affected by spasticity-related complications. Future
research aimed at integrating both active and passive motor assessments, alongside patient selfreports, will enable a more holistic understanding of spasticity and enhance the precision of its
evaluation. Assessing spasticity through the combined consideration of active and passive factors will
lead to a deeper comprehension of the condition, significantly improving the accuracy of diagnostic
evaluations.

Proje Numarası

-

Kaynakça

  • Mukherjee A, Chakravarty A. Spasticity mechanisms - for the clinician. Frontiers in neurology, 2010;1, 149.
  • Good JM. The study of medicine, vol 4. Baldwin, Cradock and Joy, London, 1829;182.
  • Thilmann A.F. Spasticity: History, Definitions, and Usage of the Term. In: Thilmann AF, Burke DJ, Rymer WZ. (eds) Spasticity. Springer, Berlin, Heidelberg, 1993; 245.
  • Lance JW. “Symposium,” in Spasticity: Disordered motor control, eds RG Feldman, RR Young, and WP Koella (Chicago: Year Book Medical Pubs), 1980;485–495.
  • Li S, Francisco GE, Rymer WZ. A new definition of poststroke spasticity and the interference of spasticity with motor recovery from acute to chronic stages. Neurorehabil Neural Repair. 2021;35(7):601-610.
  • Verduzco-Gutierrez M, Raghavan P, Pruente J, Moon D, List CM, Hornyak JE et al. AAPM&R consensus guidance on spasticity assessment and management. PMR. 2024;16(8):864-887.
  • Delp MD, Laughlın MH. Regulation of skeletal muscle perfusion during exercise. Acta Physiologica Scandinavica, 1998;162(3): 411-419.
  • Masi AT, Hannon JC. Human resting muscle tone (HRMT): narrative introduction and modern concepts. J Bodyw Mov Ther. 2008;12(4):320-32.
  • Ganguly, J., Kulshreshtha, D., Almotiri, M., Jog, M. Muscle tone physiology and abnormalities. Toxins. 2021;13(4), 282.
  • Carello, C., Turvey, M. T. Physics and psychology of the muscle sense. Current directions in psychological science. 2004;13(1), 25-28.
  • Zhang LQ, Chen K, Kang SH, Sliwa JA, Cohen BA, Rymer WZ, et al. Characterizations of reflex and nonreflex changes in spastic multiple sclerosis. Journal of neuroscience methods, 2014;231:3-8.
  • Raghavan P. Neural basis of spasticity. In: Raghavan P, ed. Spasticity and Muscle Stiffness: Restoring Form and Function. 1st ed. Springer Nature;2022.
  • Kirischuk S, Sinning A, Blanquie O, Yang JW, Luhmann HJ, Kilb W. Modulation of neocortical development by early neuronal activity: physiology and pathophysiology. Front Cell Neurosci. 2017;11:379.
  • Pandyan AD, Gregoric M, Barnes MP. Spasticity: clinical perceptions, neurological realities and meaningful measurement. Disabil Rehabil. 2005;27(1–2):2-6.
  • Sáinz-Pelayo MP, Albu S, Murillo N, Benito-Penalva J. Spasticity in neurological pathologies. An update on the pathophysiological mechanisms, advances in diagnosis and treatment. Rev Neurol. 2020;70(12):453-460.
  • Stecco, A., Stecco, C., Raghavan, P. Peripheral mechanisms contributing to spasticity and implications for treatment. Current Physical Medicine and Rehabilitation Reports. 2014;2, 121-127.
  • Xu, D., Wu, Y. N., Gaebler Spira, D., Gao, F., Clegg, N. J., Delgado, M. R., Zhang, L. Q. Neural and nonneural contributions to ankle spasticity in children with cerebral palsy. Developmental Medicine & Child Neurology. 2020;62(9), 1040-1046.
  • Gormley ME Jr, Krach LE, Piccini L. Spasticity management in the child with spastic quadriplegia. Eur J Neurol. 2001;8(Suppl 5):127-135.
  • Flanigan M, Gaebler-Spira D, Kocherginsky M, Garrett A, Marciniak C. Spasticity and pain in adults with cerebral palsy. Dev Med Child Neurol. 2020;62(3):379-385.
  • Lin JP, Brown JK, Brotherstone R. Assessment of spasticity in hemiplegic cerebral palsy. II: Distal lower-limb reflex excitability and function. Dev Med Child Neurol. 1994;36:290-303.
  • Mutlu A, Livanelioglu A, Gunel MK. Reliability of Ashworth and Modified Ashworth scales in children with spastic cerebral palsy. BMC Musculoskelet Disord. 2008;9:44.
  • Clopton N, Dutton J, Featherston T, Grigsby A, Mobley J, Melvin J. Interrater and intrarater reliability of the modified ashworth scale in children with hypertonia. Pediatr Phys Ther 2005;17:268-274.
  • Gregson JM, Leathley M, Moore AP, Sharma AK, Smith TL, Watkins CL: Reliability of the tone assessment scale and the modified ashworth scale as clinical tools for assessing poststroke spasticity. Arch Phys Med Rehabil. 1999;80:1013-1016.
  • Hugos CL, Cameron MH. Assessment and measurement of spasticity in MS: State of the Evidence. Curr Neurol Neurosci Rep. 2019;19(10):79.
  • Yee J, Low CY, Mohamad Hashim N, Che Zakaria NA, Johar K, Othman NA et al. Clinical Spasticity Assessment Assisted by Machine Learning Methods and Rule-Based Decision. Diagnostics. 2023;13:73-9.
  • He J, Luo A, Yu J, Qian C, Liu D, Hou M, et al. Quantitative assessment of spasticity: a narrative review of novel approaches and technologies. Front Neurol. 2023;14:1121323.
  • Patrick E, Ada L. The Tardieu Scale differentiates contracture from spasticity whereas the Ashworth Scale is confounded by it. Clin Rehabil. 2006;20:173– 82.
  • Haugh AB, Pandyan AD, Johnson GR. A systematic review of the Tardieu Scale for the measurement of spasticity. Disabil Rehabil. 2006;28:899–907.
  • Li F, Wu YD, Xiong L. Reliability of a new scale for measurement of spasticity in stroke patients. J Rehabil Med. 2014;46:746–53.
  • Qin W, Yang M, Li F, Chen C, Zhen L, Tian S. Influence of positional changes on spasticity of the upper extremity in poststroke hemiplegic patients. Neurosci Lett. 2019;712:134479.
  • Biering-Sørensen F, Nielsen JB, Klinge K. Spasticity-assessment: a review. Spinal cord, 2008;44.12: 708.
  • Hobart JC, Riazi A, Thompson AJ, Stiles IM, Ingram W, Vickery PJ et al. Getting the measure of spasticity in multiple sclerosis: the Multiple Sclerosis Spasticity Scale (MSSS-88). Brain. 2006;129: 224–34.
  • Calame A, Singer BJ. Inter-and intra-rater reliability of the Australian spasticity assessment scale in adults with acquired brain injury. Open J Therapy Rehabil. 2015;3:77.
  • Wartenberg R. Pendulousness of the legs as a diagnostic test. Neurology. 1951;1(1):18-24.
  • Rahimi F, Eyvazpour R, Salahshour N, Azghani MR. Objective assessment of spasticity by pendulum test: a systematic review on methods of implementation and outcome measures. Biomed Eng Online. 2020;19:18.
  • Aloraini SM, Alassaf AM, Alrezgan MM, Aldaihan MM. Spasticity Measurement Tools and Their Psychometric Properties Among Children and Adolescents With Cerebral Palsy: A Systematic Review. Pediatr Phys Ther. 2022;34(4):449-463.
  • Szopa A, Domagalska-Szopa M, Kidon Z, Syczewska M. Quadriceps femoris spasticity in children with cerebral palsy: measurement with the pendulum test and relationship with gait abnormalities. J Neuroeng Rehabil. 2014;11:10.
  • Aleksić A, Popović DB. New scale for assessing spasticity based on the pendulum test. Comput Methods Biomech Biomed Engin. 2022;25(6):593-602.
  • Wang C, Peng L, Hou ZG, Zhang P. The assessment of upper-limb spasticity based on a multi-layer process using a portable measurement system. IEEE Trans Neural Syst Rehabil Eng. 2021;29:2242–51.
  • Choi S, Shin YB, Kim SY, Kim JA novel sensor-based assessment of lower limb spasticity in children with cerebral palsy. J Neuroeng Rehabil. 2018;15:16.
  • Zhang H, Xiao Z, Wang J, Li F, Szczerbicki E. A novel IoT-perceptive human activity recognition (HAR) approach using multihead convolutional attention. IEEE Int Things J. 2020;7:1072–80.
  • Kohan AH, Abootalebi S, Khoshnevisan A, Rahgozar M. Comparison of modified Ashworth scale and Hoffmann reflex in study of spasticity. Acta Med Iran. 2010;48(3):154-157.
  • Germanotta M, Taborri J, Rossi S, Frascarelli F, Palermo E, Cappa P et al. Spasticity measurement based on tonic stretch reflex threshold in children with cerebral palsy using the PediAnklebot. Front Hum Neurosci. 2017;11:277.
  • Nourizadeh, M., Shadgan, B., Abbasidezfouli, S. Juricic M, Mulpuri K. Methods of muscle spasticity assessment in children with cerebral palsy: a scoping review. J Orthop Surg Res 2024;19:401.
  • Malhotra S, Pandyan AD, Day CR, Jones PW, Hermens H. Spasticity, an impairment that is poorly defined and poorly measured. Clin Rehabil. 2009;23(7):651-658.
  • Cherni Y, Ballaz L, Girardin-Vignola G, Begon M. Intra- and inter-tester reliability of spasticity assessment in standing position in children and adolescents with cerebral palsy using a paediatric exoskeleton. Disabil Rehabil. 2021;43:1001– 7.
  • Schmartz AC, Meyer-Heim AD, Muller R, Bolliger M. Measurement of muscle stiffness using robotic assisted gait orthosis in children with cere- bral palsy: a proof of concept. Disabil Rehabil Assist Technol. 2011;6(1): 29-37.
  • Rydahl SJ, Brouwer BJ. Ankle stiffness and tissue compliance in stroke survivors: a validation of Myotonometer measurements. Arch Phys Med Rehabil. 2004;851631–7.
  • Yamaguchi T, Petersen TH, Kirk H, Forman C, Svane C, Kofoed-Hansen M et al. Spasticity in adults with cerebral palsy and multiple sclerosis measured by objective clinically applicable technique. Clin Neurophysiol. 2018;129:2010– 21.
  • Li X, Shin H, Li S, Zhou P. Assessing muscle spasticity with Myotonometric and passive stretch measurements: validity of the Myotonometer. Sci Rep. 2017;7:44022.
  • Lin MT, Yang SM, Wu HW, Chen YH, Wu CH. Utility of ultrasound elastography to evaluate poststroke spasticity and therapeutic efficacy: A narrative review. J Med Ultrasound. 2023;31:171-7.
  • Wu CH, Lin YY, Chen WS, Wang TG. Sonoelastographic evaluation of plantar fascia after shock wave therapy for recalcitrant plantar fasciitis: A 12-month longitudinal follow-up study. Sci Rep. 2020;10:2571.
  • Sigrist RMS, Liau J, Kaffas AE, Chammas MC, Willmann JK. Ultrasound Elastography: Review of Techniques and Clinical Applications. Theranostics. 2017; 7:1303-1329.
  • Ferrari M, Mottola L, Quaresima V. Principles, techniques, and limitations of near infrared spectroscopy, Can. J. Appl. Physiol. 2004; 29:463–487.
  • McDougall J, Chow E, Harris RL, Mills PB. Near-infrared spectroscopy as a quantitative spasticity assessment tool: A systematic review. J Neurol Sci. 2020;412:116729.
  • Bar-On L. Aertbeliën E, Molenaers G, Desloovere K. Muscle activation patterns when passively stretching spastic lower limb muscles of children with cerebral palsy. PLoS one. 2014;9:e917-59.
  • Van der Krogt MM, Bar-On L. Kindt T, Desloovere K, Harlaar J. Neuro-musculoskeletal simulation of instrumented contracture and spasticity assessment in children with cerebral palsy. J Neuroeng Rehabil. 2016; 13:11.
  • Yee J, Low CY, Hashim NM, Hanapiah FA, Soh WS, Zakaria NAC et al. Data-driven model for upper limb spasticity detection. Int J Integ Eng. 2021; 13:180–8.
  • Park J-H, Lee K-J, Yoon Y-S, Son E-J, Oh J-S, Kang SH et al. Development of elbow spasticity model for objective training of spasticity assessment of patients post stroke. IEEE Int Conf Rehabil Robot. 2017:146–51.
  • Amit M, Yalcin C, Liu J, Skalsky A, Garudadri H, Nga N. Multimodal assessment of spasticity using a point-of-care instrumented glove to separate neural and biomechanical contributions. iScience. 2022; 25;10,5286.
  • Verduzco-Gutierrez M, Bean AC, Tenforde AS, Tapia RN, Silver JK. How to conduct an outpatient telemedicine rehabilitation or prehabilitation visit. PM R. 2020;12:714–20.
  • Harper KA, Butler EC, Hacker ML, Naik A, Eoff BR, Phibbs FT et al. A comparative evaluation of telehealth and direct assessment when screening for spasticity in residents of two long-term care facilities. Clin Rehabil. 2021;35:589–94.
  • Kim J, Sin M, Kim WS, Min YS, Kim W, Park D et al. Remote assessment of post-stroke elbow function using internet-based telerobotics: a proof-of-concept study. Front Neurol. 2020;11:583101.
  • De Donno A, Acella A, Angrisani C, Gubinelli G, Musci G, Gravili G et al. Suspension of care for patients with spasticity during COVID-19 pandemic: ethical and medico-legal point of view starting from an Italian study. Front Med. 2021;8:10.
  • Knox L, McDermott C, Hobson E. Telehealth in long-term neurological conditions: the potential, the challenges and the key recommendations. J Med Eng Technol. 2022; 46:1–12.

Spastisite Mekanizması ve Güncel Değerlendirme Yöntemleri

Yıl 2025, Cilt: 6 Sayı: 1, 9 - 22, 30.04.2025
https://doi.org/10.58208/cphs.1505389

Öz

Spastisite, artmış kas tonusu ve abartılı reflekslerle karakterize edilen; inme, serebral palsi ve multipl
skleroz gibi çeşitli nörolojik hastalıklarda yaygın olarak görülen klinik bir belirtidir. Spastisitenin
doğru ve kapsamlı şekilde değerlendirilmesi, etkili tedavi planlaması ve prognoz takibi açısından
büyük önem taşımaktadır. Bu makale, spastisitenin altında yatan karmaşık mekanizmaları araştırmayı
ve spastisiteyi değerlendirmede kullanılan güncel yöntemleri geniş bir bakış açısıyla ele almayı
amaçlamaktadır. Sağlık profesyonellerinin, spastisite mekanizmalarını daha iyi anlayarak yenilikçi
değerlendirme araçlarından faydalanması, tedavi stratejilerinin geliştirilmesine ve spastisite ile ilişkili
sorunları olan bireyler için sonuçların iyileştirilmesine katkı sağlayacaktır. Gelecekteki
araştırmaların, aktif ve pasif motor değerlendirmelerini birleştirmeye ve hasta öz bildirimlerini dahil
etmeye odaklanması ile, spastisiteyi daha bütüncül bir perspektiften anlamak ve değerlendirme
doğruluğunu artırmak mümkün olacaktır. Aktif ve pasif yönleri bir arada değerlendirerek, spastisite
hakkında daha derinlemesine bir anlayış elde edilebilir ve bu durum, değerlendirme doğruluğunu
önemli ölçüde artırabilir.

Proje Numarası

-

Kaynakça

  • Mukherjee A, Chakravarty A. Spasticity mechanisms - for the clinician. Frontiers in neurology, 2010;1, 149.
  • Good JM. The study of medicine, vol 4. Baldwin, Cradock and Joy, London, 1829;182.
  • Thilmann A.F. Spasticity: History, Definitions, and Usage of the Term. In: Thilmann AF, Burke DJ, Rymer WZ. (eds) Spasticity. Springer, Berlin, Heidelberg, 1993; 245.
  • Lance JW. “Symposium,” in Spasticity: Disordered motor control, eds RG Feldman, RR Young, and WP Koella (Chicago: Year Book Medical Pubs), 1980;485–495.
  • Li S, Francisco GE, Rymer WZ. A new definition of poststroke spasticity and the interference of spasticity with motor recovery from acute to chronic stages. Neurorehabil Neural Repair. 2021;35(7):601-610.
  • Verduzco-Gutierrez M, Raghavan P, Pruente J, Moon D, List CM, Hornyak JE et al. AAPM&R consensus guidance on spasticity assessment and management. PMR. 2024;16(8):864-887.
  • Delp MD, Laughlın MH. Regulation of skeletal muscle perfusion during exercise. Acta Physiologica Scandinavica, 1998;162(3): 411-419.
  • Masi AT, Hannon JC. Human resting muscle tone (HRMT): narrative introduction and modern concepts. J Bodyw Mov Ther. 2008;12(4):320-32.
  • Ganguly, J., Kulshreshtha, D., Almotiri, M., Jog, M. Muscle tone physiology and abnormalities. Toxins. 2021;13(4), 282.
  • Carello, C., Turvey, M. T. Physics and psychology of the muscle sense. Current directions in psychological science. 2004;13(1), 25-28.
  • Zhang LQ, Chen K, Kang SH, Sliwa JA, Cohen BA, Rymer WZ, et al. Characterizations of reflex and nonreflex changes in spastic multiple sclerosis. Journal of neuroscience methods, 2014;231:3-8.
  • Raghavan P. Neural basis of spasticity. In: Raghavan P, ed. Spasticity and Muscle Stiffness: Restoring Form and Function. 1st ed. Springer Nature;2022.
  • Kirischuk S, Sinning A, Blanquie O, Yang JW, Luhmann HJ, Kilb W. Modulation of neocortical development by early neuronal activity: physiology and pathophysiology. Front Cell Neurosci. 2017;11:379.
  • Pandyan AD, Gregoric M, Barnes MP. Spasticity: clinical perceptions, neurological realities and meaningful measurement. Disabil Rehabil. 2005;27(1–2):2-6.
  • Sáinz-Pelayo MP, Albu S, Murillo N, Benito-Penalva J. Spasticity in neurological pathologies. An update on the pathophysiological mechanisms, advances in diagnosis and treatment. Rev Neurol. 2020;70(12):453-460.
  • Stecco, A., Stecco, C., Raghavan, P. Peripheral mechanisms contributing to spasticity and implications for treatment. Current Physical Medicine and Rehabilitation Reports. 2014;2, 121-127.
  • Xu, D., Wu, Y. N., Gaebler Spira, D., Gao, F., Clegg, N. J., Delgado, M. R., Zhang, L. Q. Neural and nonneural contributions to ankle spasticity in children with cerebral palsy. Developmental Medicine & Child Neurology. 2020;62(9), 1040-1046.
  • Gormley ME Jr, Krach LE, Piccini L. Spasticity management in the child with spastic quadriplegia. Eur J Neurol. 2001;8(Suppl 5):127-135.
  • Flanigan M, Gaebler-Spira D, Kocherginsky M, Garrett A, Marciniak C. Spasticity and pain in adults with cerebral palsy. Dev Med Child Neurol. 2020;62(3):379-385.
  • Lin JP, Brown JK, Brotherstone R. Assessment of spasticity in hemiplegic cerebral palsy. II: Distal lower-limb reflex excitability and function. Dev Med Child Neurol. 1994;36:290-303.
  • Mutlu A, Livanelioglu A, Gunel MK. Reliability of Ashworth and Modified Ashworth scales in children with spastic cerebral palsy. BMC Musculoskelet Disord. 2008;9:44.
  • Clopton N, Dutton J, Featherston T, Grigsby A, Mobley J, Melvin J. Interrater and intrarater reliability of the modified ashworth scale in children with hypertonia. Pediatr Phys Ther 2005;17:268-274.
  • Gregson JM, Leathley M, Moore AP, Sharma AK, Smith TL, Watkins CL: Reliability of the tone assessment scale and the modified ashworth scale as clinical tools for assessing poststroke spasticity. Arch Phys Med Rehabil. 1999;80:1013-1016.
  • Hugos CL, Cameron MH. Assessment and measurement of spasticity in MS: State of the Evidence. Curr Neurol Neurosci Rep. 2019;19(10):79.
  • Yee J, Low CY, Mohamad Hashim N, Che Zakaria NA, Johar K, Othman NA et al. Clinical Spasticity Assessment Assisted by Machine Learning Methods and Rule-Based Decision. Diagnostics. 2023;13:73-9.
  • He J, Luo A, Yu J, Qian C, Liu D, Hou M, et al. Quantitative assessment of spasticity: a narrative review of novel approaches and technologies. Front Neurol. 2023;14:1121323.
  • Patrick E, Ada L. The Tardieu Scale differentiates contracture from spasticity whereas the Ashworth Scale is confounded by it. Clin Rehabil. 2006;20:173– 82.
  • Haugh AB, Pandyan AD, Johnson GR. A systematic review of the Tardieu Scale for the measurement of spasticity. Disabil Rehabil. 2006;28:899–907.
  • Li F, Wu YD, Xiong L. Reliability of a new scale for measurement of spasticity in stroke patients. J Rehabil Med. 2014;46:746–53.
  • Qin W, Yang M, Li F, Chen C, Zhen L, Tian S. Influence of positional changes on spasticity of the upper extremity in poststroke hemiplegic patients. Neurosci Lett. 2019;712:134479.
  • Biering-Sørensen F, Nielsen JB, Klinge K. Spasticity-assessment: a review. Spinal cord, 2008;44.12: 708.
  • Hobart JC, Riazi A, Thompson AJ, Stiles IM, Ingram W, Vickery PJ et al. Getting the measure of spasticity in multiple sclerosis: the Multiple Sclerosis Spasticity Scale (MSSS-88). Brain. 2006;129: 224–34.
  • Calame A, Singer BJ. Inter-and intra-rater reliability of the Australian spasticity assessment scale in adults with acquired brain injury. Open J Therapy Rehabil. 2015;3:77.
  • Wartenberg R. Pendulousness of the legs as a diagnostic test. Neurology. 1951;1(1):18-24.
  • Rahimi F, Eyvazpour R, Salahshour N, Azghani MR. Objective assessment of spasticity by pendulum test: a systematic review on methods of implementation and outcome measures. Biomed Eng Online. 2020;19:18.
  • Aloraini SM, Alassaf AM, Alrezgan MM, Aldaihan MM. Spasticity Measurement Tools and Their Psychometric Properties Among Children and Adolescents With Cerebral Palsy: A Systematic Review. Pediatr Phys Ther. 2022;34(4):449-463.
  • Szopa A, Domagalska-Szopa M, Kidon Z, Syczewska M. Quadriceps femoris spasticity in children with cerebral palsy: measurement with the pendulum test and relationship with gait abnormalities. J Neuroeng Rehabil. 2014;11:10.
  • Aleksić A, Popović DB. New scale for assessing spasticity based on the pendulum test. Comput Methods Biomech Biomed Engin. 2022;25(6):593-602.
  • Wang C, Peng L, Hou ZG, Zhang P. The assessment of upper-limb spasticity based on a multi-layer process using a portable measurement system. IEEE Trans Neural Syst Rehabil Eng. 2021;29:2242–51.
  • Choi S, Shin YB, Kim SY, Kim JA novel sensor-based assessment of lower limb spasticity in children with cerebral palsy. J Neuroeng Rehabil. 2018;15:16.
  • Zhang H, Xiao Z, Wang J, Li F, Szczerbicki E. A novel IoT-perceptive human activity recognition (HAR) approach using multihead convolutional attention. IEEE Int Things J. 2020;7:1072–80.
  • Kohan AH, Abootalebi S, Khoshnevisan A, Rahgozar M. Comparison of modified Ashworth scale and Hoffmann reflex in study of spasticity. Acta Med Iran. 2010;48(3):154-157.
  • Germanotta M, Taborri J, Rossi S, Frascarelli F, Palermo E, Cappa P et al. Spasticity measurement based on tonic stretch reflex threshold in children with cerebral palsy using the PediAnklebot. Front Hum Neurosci. 2017;11:277.
  • Nourizadeh, M., Shadgan, B., Abbasidezfouli, S. Juricic M, Mulpuri K. Methods of muscle spasticity assessment in children with cerebral palsy: a scoping review. J Orthop Surg Res 2024;19:401.
  • Malhotra S, Pandyan AD, Day CR, Jones PW, Hermens H. Spasticity, an impairment that is poorly defined and poorly measured. Clin Rehabil. 2009;23(7):651-658.
  • Cherni Y, Ballaz L, Girardin-Vignola G, Begon M. Intra- and inter-tester reliability of spasticity assessment in standing position in children and adolescents with cerebral palsy using a paediatric exoskeleton. Disabil Rehabil. 2021;43:1001– 7.
  • Schmartz AC, Meyer-Heim AD, Muller R, Bolliger M. Measurement of muscle stiffness using robotic assisted gait orthosis in children with cere- bral palsy: a proof of concept. Disabil Rehabil Assist Technol. 2011;6(1): 29-37.
  • Rydahl SJ, Brouwer BJ. Ankle stiffness and tissue compliance in stroke survivors: a validation of Myotonometer measurements. Arch Phys Med Rehabil. 2004;851631–7.
  • Yamaguchi T, Petersen TH, Kirk H, Forman C, Svane C, Kofoed-Hansen M et al. Spasticity in adults with cerebral palsy and multiple sclerosis measured by objective clinically applicable technique. Clin Neurophysiol. 2018;129:2010– 21.
  • Li X, Shin H, Li S, Zhou P. Assessing muscle spasticity with Myotonometric and passive stretch measurements: validity of the Myotonometer. Sci Rep. 2017;7:44022.
  • Lin MT, Yang SM, Wu HW, Chen YH, Wu CH. Utility of ultrasound elastography to evaluate poststroke spasticity and therapeutic efficacy: A narrative review. J Med Ultrasound. 2023;31:171-7.
  • Wu CH, Lin YY, Chen WS, Wang TG. Sonoelastographic evaluation of plantar fascia after shock wave therapy for recalcitrant plantar fasciitis: A 12-month longitudinal follow-up study. Sci Rep. 2020;10:2571.
  • Sigrist RMS, Liau J, Kaffas AE, Chammas MC, Willmann JK. Ultrasound Elastography: Review of Techniques and Clinical Applications. Theranostics. 2017; 7:1303-1329.
  • Ferrari M, Mottola L, Quaresima V. Principles, techniques, and limitations of near infrared spectroscopy, Can. J. Appl. Physiol. 2004; 29:463–487.
  • McDougall J, Chow E, Harris RL, Mills PB. Near-infrared spectroscopy as a quantitative spasticity assessment tool: A systematic review. J Neurol Sci. 2020;412:116729.
  • Bar-On L. Aertbeliën E, Molenaers G, Desloovere K. Muscle activation patterns when passively stretching spastic lower limb muscles of children with cerebral palsy. PLoS one. 2014;9:e917-59.
  • Van der Krogt MM, Bar-On L. Kindt T, Desloovere K, Harlaar J. Neuro-musculoskeletal simulation of instrumented contracture and spasticity assessment in children with cerebral palsy. J Neuroeng Rehabil. 2016; 13:11.
  • Yee J, Low CY, Hashim NM, Hanapiah FA, Soh WS, Zakaria NAC et al. Data-driven model for upper limb spasticity detection. Int J Integ Eng. 2021; 13:180–8.
  • Park J-H, Lee K-J, Yoon Y-S, Son E-J, Oh J-S, Kang SH et al. Development of elbow spasticity model for objective training of spasticity assessment of patients post stroke. IEEE Int Conf Rehabil Robot. 2017:146–51.
  • Amit M, Yalcin C, Liu J, Skalsky A, Garudadri H, Nga N. Multimodal assessment of spasticity using a point-of-care instrumented glove to separate neural and biomechanical contributions. iScience. 2022; 25;10,5286.
  • Verduzco-Gutierrez M, Bean AC, Tenforde AS, Tapia RN, Silver JK. How to conduct an outpatient telemedicine rehabilitation or prehabilitation visit. PM R. 2020;12:714–20.
  • Harper KA, Butler EC, Hacker ML, Naik A, Eoff BR, Phibbs FT et al. A comparative evaluation of telehealth and direct assessment when screening for spasticity in residents of two long-term care facilities. Clin Rehabil. 2021;35:589–94.
  • Kim J, Sin M, Kim WS, Min YS, Kim W, Park D et al. Remote assessment of post-stroke elbow function using internet-based telerobotics: a proof-of-concept study. Front Neurol. 2020;11:583101.
  • De Donno A, Acella A, Angrisani C, Gubinelli G, Musci G, Gravili G et al. Suspension of care for patients with spasticity during COVID-19 pandemic: ethical and medico-legal point of view starting from an Italian study. Front Med. 2021;8:10.
  • Knox L, McDermott C, Hobson E. Telehealth in long-term neurological conditions: the potential, the challenges and the key recommendations. J Med Eng Technol. 2022; 46:1–12.
Toplam 65 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Rehabilitasyon
Bölüm Derleme
Yazarlar

Sezen Karabörklü Argut 0000-0002-7466-8105

Proje Numarası -
Gönderilme Tarihi 26 Haziran 2024
Kabul Tarihi 4 Kasım 2024
Yayımlanma Tarihi 30 Nisan 2025
Yayımlandığı Sayı Yıl 2025 Cilt: 6 Sayı: 1

Kaynak Göster

Vancouver Karabörklü Argut S. Spastisite Mekanizması ve Güncel Değerlendirme Yöntemleri. SBGY. 2025;6(1):9-22.