Inertia Sensors for Measuring Spasticity of the Ankle Plantarflexors Using the Modified Tardieu Scale-A Proof of Concept Study.

Ankle spasticity is clinically assessed using goniometry to measure the angle of muscle reaction during the Modified Tardieu Scale (MTS). The precision of the goniometric method is questionable as the measured angle may not represent when the spastic muscle reaction occurred. This work proposes a method to accurately determine the angle of muscle reaction during the MTS assessment by measuring the maximum angular velocity and the corresponding ankle joint angle, using two affordable inertial sensors. Initially we identified the association between muscle onset and peak joint angular velocity using surface electromyography and an inertial sensor. The maximum foot angular velocity occurred 0.049 and 0.032 s following the spastic muscle reaction for Gastrocnemius and Soleus, respectively. Next, we explored the use of two affordable inertial sensors to identify the angle of muscle reaction using the peak ankle angular velocity. The angle of muscle reaction and the maximum dorsiflexion angle were significantly different for both Gastrocnemius and Soleus MTS tests ( = 0.028 and = 0.009, respectively), indicating that the system is able to accurately detect a spastic muscle response before the end of the movement. This work successfully demonstrates how wearable technology can be used in a clinical setting to identify the onset of muscle spasticity and proposes a more accurate method that clinicians can use to measure the angle of muscle reaction during the MTS assessment. Furthermore, the proposed method may provide an opportunity to monitor the degree of spasticity where the direct help of experienced therapists is inaccessible, e.g., in rural or remote areas.