Assessment of passive knee stiffness and viscosity in individuals with spinal cord injury using pendulum test

The Journal of Spinal Cord Medicine, 2015 · DOI: 10.1179/2045772314Y.0000000265 · Published: January 1, 2015

Spinal Cord Injury Rehabilitation Biomechanics

Simple Explanation

This study investigates knee stiffness and viscosity in people with spinal cord injuries (SCI). Stiffness and viscosity are measures of the passive resistance to joint movement. The Wartenberg pendulum test was used to measure these parameters. This test involves letting the lower leg swing freely and measuring its movement. The study found that individuals with SCI have significantly greater knee stiffness compared to healthy individuals, but no significant difference in viscosity.

Study Duration

Not specified

Participants

30 subjects: 15 with paraplegic SCI and 15 able-bodied controls

Evidence Level

Non-experimental, cross-sectional, case–control design

Key Findings

1
Patients with SCI have significantly greater joint stiffness compared to able-bodied subjects.
2
No significant difference was found in the viscosity between two groups.
3
Except for first peak flexion angle, all other displacement kinematic parameters exhibited no statistically significant difference between normal subjects and subjects with SCI.

Research Summary

The study measured knee joint stiffness and viscosity in individuals with SCI and healthy controls using the Wartenberg pendulum test. Results showed significantly greater stiffness in SCI patients compared to healthy subjects, but no significant difference in viscosity. The increased stiffness in SCI patients may be related to spasticity, altered muscle tone, and changes in muscle fiber types.

Practical Implications

Rehabilitation Program Design

The findings can inform the design of rehabilitation programs for SCI patients, focusing on reducing knee stiffness through passive movements and other interventions.

Accurate Musculoskeletal Modeling

The greater stiffness observed in SCI patients should be considered for accurate modeling of the musculoskeletal system, particularly in the context of functional electrical stimulation.

Treatment Strategy Development

The study supports the importance of testing and estimating joint stiffness to inform effective treatment strategies for patients with paraplegia due to SCI.

Study Limitations

1
Lack of electromyography (EMG) data to assess muscular activity during the test.
2
Absence of reliability assessment in the study, although the pendulum test has been previously established as reliable.
3
More clinical studies are needed to determine the therapeutic effect of different treatment methods or rehabilitation programs on stiffness or viscosity in patients with paraplegic SCI.

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