Is the Silfverskiöld Test a valid tool for evaluating calf muscles spastic overactivity in patients with stroke? A retrospective observational study.
Alessandro Picelli, Rita DI Censo, Cecilia Angeli and 5 others
PMID 39257332WHAT IT FOUND
The Silfverskiöld Test did not accurately distinguish which calf muscles were causing spasticity in stroke patients.
It failed to predict the results of selective nerve blocks, suggesting clinicians should not rely on this test alone to decide which muscles to treat.
Key findings
01There was no statistical association between the Silfverskiöld Test results and the specific muscles identified by selective nerve blocks as having spastic overactivity.
02The authors conclude that the Silfverskiöld Test is not a valid tool for differentiating between gastrocnemius, soleus, and tibialis posterior spastic muscle overactivity in stroke patients.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study was retrospective, meaning it relied on existing charts rather than a controlled, prospective design. Patients were not standardized regarding their prior treatments or specific clinical profiles due to the chart review nature. The study did not include data on botulinum toxin (BoNT-A) outcomes, so it is unclear if the test's failure to identify muscles via nerve block translates to poor guidance for toxin injections. Active range of motion and electromyography data were not available for all patients.
Declared interests
Several authors received research funds, honoraria, and financial support, and have consultant relationships, though these were stated as topically but not directly related to the manuscript.
The easy way to misread this
Do not assume the Silfverskiöld Test is useless for all purposes; this study only shows it fails to distinguish between specific calf muscles in spastic stroke patients. It may still be valid for its original purpose of assessing contracture deformity types.