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Manual Linear Movements to Assess Spasticity in a Clinical Setting

In a clinical setting, where motor-driven systems are not readily available, the major difficulty in the assessment of the stretch reflex lies in the control of passive limb displacement velocity. A potential approach to this problem arises from the use of manual sinusoidal movements (made by contin...

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Autores principales: Marinelli, Lucio, Trompetto, Carlo, Mori, Laura, Vigo, Gabriele, Traverso, Elisabetta, Colombano, Federica, Abbruzzese, Giovanni
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3546077/
https://www.ncbi.nlm.nih.gov/pubmed/23335966
http://dx.doi.org/10.1371/journal.pone.0053627
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author Marinelli, Lucio
Trompetto, Carlo
Mori, Laura
Vigo, Gabriele
Traverso, Elisabetta
Colombano, Federica
Abbruzzese, Giovanni
author_facet Marinelli, Lucio
Trompetto, Carlo
Mori, Laura
Vigo, Gabriele
Traverso, Elisabetta
Colombano, Federica
Abbruzzese, Giovanni
author_sort Marinelli, Lucio
collection PubMed
description In a clinical setting, where motor-driven systems are not readily available, the major difficulty in the assessment of the stretch reflex lies in the control of passive limb displacement velocity. A potential approach to this problem arises from the use of manual sinusoidal movements (made by continuous alternating flexions and extensions) paced by an external stimulus. Unfortunately, there are conditions in which sinusoidal movements induce interfering phenomena such as the shortening reaction or postactivation depression. In the present paper, a novel manual method to control the velocity of passive linear movements is described and the results obtained from both healthy subjects and spastic patients are reported. This method is based on the synchronisation of movements with tones played by a metronome at different speeds. In a first set of experiments performed in healthy subjects, we demonstrated consistent control of velocity during passive limb movements using this method. Four joints usually examined during muscle tone assessment were tested: wrist, elbow, knee and ankle joints. Following this, we conducted a longitudinal assessment of the stretch reflex amplitude in wrist flexor muscles in patients with spasticity treated with botulinum toxin type A. The evaluators were not only able to vary the movement velocity based on the metronome speed, but also could reproduce the respective speeds two weeks later, despite the changing degree of hypertonia. This method is easy to perform in a clinical setting and hardware requirements are minimal, making it an attractive and robust procedure for the widespread clinical assessment of reflex hypertonia.
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spelling pubmed-35460772013-01-18 Manual Linear Movements to Assess Spasticity in a Clinical Setting Marinelli, Lucio Trompetto, Carlo Mori, Laura Vigo, Gabriele Traverso, Elisabetta Colombano, Federica Abbruzzese, Giovanni PLoS One Research Article In a clinical setting, where motor-driven systems are not readily available, the major difficulty in the assessment of the stretch reflex lies in the control of passive limb displacement velocity. A potential approach to this problem arises from the use of manual sinusoidal movements (made by continuous alternating flexions and extensions) paced by an external stimulus. Unfortunately, there are conditions in which sinusoidal movements induce interfering phenomena such as the shortening reaction or postactivation depression. In the present paper, a novel manual method to control the velocity of passive linear movements is described and the results obtained from both healthy subjects and spastic patients are reported. This method is based on the synchronisation of movements with tones played by a metronome at different speeds. In a first set of experiments performed in healthy subjects, we demonstrated consistent control of velocity during passive limb movements using this method. Four joints usually examined during muscle tone assessment were tested: wrist, elbow, knee and ankle joints. Following this, we conducted a longitudinal assessment of the stretch reflex amplitude in wrist flexor muscles in patients with spasticity treated with botulinum toxin type A. The evaluators were not only able to vary the movement velocity based on the metronome speed, but also could reproduce the respective speeds two weeks later, despite the changing degree of hypertonia. This method is easy to perform in a clinical setting and hardware requirements are minimal, making it an attractive and robust procedure for the widespread clinical assessment of reflex hypertonia. Public Library of Science 2013-01-15 /pmc/articles/PMC3546077/ /pubmed/23335966 http://dx.doi.org/10.1371/journal.pone.0053627 Text en © 2013 Marinelli et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Marinelli, Lucio
Trompetto, Carlo
Mori, Laura
Vigo, Gabriele
Traverso, Elisabetta
Colombano, Federica
Abbruzzese, Giovanni
Manual Linear Movements to Assess Spasticity in a Clinical Setting
title Manual Linear Movements to Assess Spasticity in a Clinical Setting
title_full Manual Linear Movements to Assess Spasticity in a Clinical Setting
title_fullStr Manual Linear Movements to Assess Spasticity in a Clinical Setting
title_full_unstemmed Manual Linear Movements to Assess Spasticity in a Clinical Setting
title_short Manual Linear Movements to Assess Spasticity in a Clinical Setting
title_sort manual linear movements to assess spasticity in a clinical setting
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3546077/
https://www.ncbi.nlm.nih.gov/pubmed/23335966
http://dx.doi.org/10.1371/journal.pone.0053627
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