Clinometric properties of a clinical spasticity measurement tool.

PURPOSE

To investigate clinometric properties of an Anglo-Dutch spasticity measurement tool (ADSMT), an objective tool providing information about both neurophysiological and biomechanical aspects of spasticity about the wrist joint in the clinical setting.

METHOD

ADSMT measurements were performed with 12 healthy and 11 participants with post-stroke spasticity, and consisted of assessing the maximum range of passive wrist movement (pROM) and passive wrist extension at different cycle rates. Outcome measures were wrist angle, flexor and extensor activation, and resistance to movement. Intra-class Correlation Coefficients (ICCs) were calculated for inter-rater and test-retest reliability. Validity was investigated by calculating Spearman's rho between ADSMT outcome measures and the Modified Ashworth Scale (n=12), the Action Research Arm Test (n=6), and a validated wrist rig (n=6).

RESULTS

Impaired participants had higher flexor activity and higher resistance to movement during passive wrist extension compared to unimpaired participants. For all outcome measures inter-rater and test-retest reliability were satisfactory to good and concurrent validity was sufficient.

CONCLUSIONS

Outcome measures related to wrist flexor activity and resistance to movement during extension are promising for spasticity assessment using the ADSMT. Further knowledge on reference values and practicality is necessary for this tool to become incorporated in the clinical setting.