Quantitative measurement of resistance force and subsequent attenuation during passive isokinetic extension of the wrist in patients with mild to moderate spasticity after stroke.
Kentaro Kawamura, Seiji Etoh, Tomokazu Noma and 6 others
PMID 36224659WHAT IT FOUND
A custom wrist device measured spasticity in 17 stroke patients.
It found no link between peak resistance and clinical scores, but the rate of force drop-off correlated with severity, especially when finger spasticity was included in the assessment.
Key findings
01Peak resistance force during passive wrist extension did not correlate with Modified Ashworth Scale scores.
02Normalized damping ratios (force drop-off after peak) correlated with clinical spasticity scores, particularly when finger flexor spasticity was included in the average.
03Patients with moderate spasticity showed significantly higher damping ratios than those with mild spasticity at higher movement speeds.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The sample size was very small (17 participants), limiting the generalizability of the findings. The inter-rater reliability for the clinical standard (MAS) was poor, especially for finger flexors, which makes the comparison against the device's data less robust. The measurements were taken in a fixed order of increasing speed, which may have caused fatigue or adaptation effects that influenced the results. The device is a custom prototype, not a commercial tool available to clinicians. The study treated MAS scores as ordinal data for statistical analysis, which some researchers argue is methodologically problematic.
Declared interests
The study was funded by the Japan Society for the Promotion of Science. No other conflicts of interest were reported.
The easy way to misread this
Do not assume the device's peak resistance measurement is a valid substitute for clinical assessment, as it showed no correlation with spasticity scores. The finding relies on a specific 'damping' ratio that requires complex normalization and may not be easily replicable in a standard clinic without this custom equipment.