Upper limb impairments associated with spasticity in neurological disorders

Journal of NeuroEngineering and Rehabilitation, 2007 · DOI: 10.1186/1743-0003-4-45 · Published: November 29, 2007

Neurology Neurorehabilitation Rehabilitation

Simple Explanation

This study investigates how spasticity, a condition causing muscle stiffness, affects arm movements in people with stroke and spinal cord injury (SCI). The goal is to understand if the type of spasticity (from brain injury in stroke versus spinal cord injury in SCI) leads to different movement problems. The researchers measured how quickly and smoothly participants could extend their elbow, along with the strength of their arm muscles. They compared these measurements between the affected and unaffected arms of stroke patients, the arms of SCI patients, and those of healthy individuals. The study found that while both stroke and SCI patients had similar difficulties with arm movement, the smoothness of movement was more affected in stroke patients. The unaffected arm in stroke patients behaved similarly to the arms of healthy individuals, suggesting it could be used as a comparison for studying the affected arm.

Study Duration

Not specified

Participants

10 stroke subjects, 8 SCI subjects, and 10 healthy subjects

Evidence Level

Not specified

Key Findings

1
Most kinematic and kinetic parameters changed significantly in paretic as compared to normal arms in stroke subjects.
2
There were no significant differences in these parameters between SCI and stroke subjects, except for the movement smoothness.
3
Extension was significantly less smooth in the paretic compared to the non-paretic arm in the stroke group, whereas it was within the normal range in the SCI group.

Research Summary

The study characterized impairments in voluntary arm movement associated with spasticity in stroke and SCI subjects. Impairments in arm voluntary movement were similar in the two spastic groups, although the cause and location of injury are different. The non-paretic arm in stroke subjects was not distinguishable from the normal arm and might be used as an appropriate control for studying movement of the paretic arm.

Practical Implications

Rehabilitation Strategies

Rehabilitation programs should consider the similarities in motor impairments between stroke and SCI patients with spasticity, while also addressing the unique smoothness deficits observed in stroke.

Control Group Selection

The non-paretic arm in stroke patients may serve as a suitable control for research studies, reducing inter-subject variability and improving the accuracy of results.

Spasticity Assessment

The Modified Ashworth Scale may not accurately reflect objective measures of voluntary movement, suggesting a need for more quantitative and reliable spasticity assessments.

Study Limitations

1
The sample size in the subgroups was small, which may have affected the statistical significance of some findings.
2
The statistical power for the comparison between non-paretic and normal arms was smaller than 40% for the measured parameters.
3
The study focused on elbow extension movements and may not generalize to other upper limb movements or functional tasks.

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