Predictive value of the pendulum test for assessing knee extensor spasticity.
Alyssa Whelan, Andrew Sexton, Melony Jones and 2 others
PMID 30021641WHAT IT FOUND
In 131 knees from 93 adults with a neurological condition or injury, pendulum test measurements could help identify knee extensor spasticity, especially first flexion amplitude plus resting angle.
They did not reliably separate low from high spasticity.
Key findings
01The pendulum test metrics studied could discriminate no extensor spasticity from any extensor spasticity, but not low/moderate from high/severe extensor spasticity.
02Flexor spasticity did not significantly influence the pendulum test metrics used to assess extensor spasticity.
03For detecting any extensor spasticity, the best model used first flexion amplitude and plateau angle together and had 77.9% classification accuracy.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The comparison standard was the Modified Ashworth Scale, which the paper notes is subjective and may mix stretch-reflex hyperexcitability with passive resistance to stretch. Because MAS may be the weak link, the failure to separate low/moderate from high/severe spasticity may not be a pendulum test problem alone. Therapist variability in MAS ratings was not analysed. No knees had MAS = 4, so full rigidity was not represented. The MS and CP cohorts were small (14 and 12 patients), and effects by cohort were not analysed. Only a few pendulum test metrics were examined, so other metrics might perform differently. Participants were selected for abnormal tone in limbs, so the findings may not apply to people without tone problems.
Declared interests
The supplied publication types list non-U.S. government research support. No author conflict-of-interest statement is included in the supplied text.
The easy way to misread this
Do not treat the pendulum test as a stand-alone severity scale. It detected any extensor spasticity better than none, but it did not reliably separate low/moderate from high/severe spasticity.