Authors

Sample

Inclusion criteria

Assessment tools

Evaluation protocol in the isokinetic dynamometer

Results/Conclusions

Perell, Scremin & Kunkel, (1996)

- 11 patients with spastic spinal cord injury;

- 6 patients with flaccid spinal cord injury;

- 10 healthy subjects (control group);

- Average time after injury: spastic group ? 9.00 ± 5.80 years; flaccid group: 17.67 ± 8.63 years;

- Variation of injury level: C5 ? L1 (spastic group) and T11 ? L1 (flaccid group).

- Medically and neurologically stable;

- Spastic muscle tone varying in degree from mild to severe based on the physical examination (Ashworth scale = 2 - 4);

- Lack of muscle tone in the flaccid subjects confirmed by physical examination (Ashworth scale = 0).

-Ashworth scale;

-Isokinetic dynamometer

Model: Kin-Com model 500R, Chattacx Co., Chattanooga, TN.

- Passive range of motion performed: 50˚, between 25˚ and 75˚ knee flexion;

- Angular velocities of passive movement: 30, 60, 120˚/s;

- Subject position: seated on a chair, hip maintained at 90˚ flexion

- Instructions to subjects: n.d.;

-Number of repetitions: 10 to 12 repetitions (for flexion and extension of the knee). For data analysis, values collected in the 5 average repetitions were used;

- Spasticity measurement: Average torque of the 5 intermediate repetitions for maximum peak (Tmax) and the sum of 4 consecutive peaks (Tsum), for each speed for each phase (flexion and extension) separately.

Maximum peak flexion (Tmax FLX) could be used to distinguish a homogenous population of complete, spastic SCI subjects from flaccid SCI subjects, and from normal able-bodied subjects. Tmax FLX of the spastic group was significantly lower at 60 and 120˚/s than that of the other two groups.

Akman et al., (1999)

- 33 patients with spinal cord injury, with different degrees of hypertonia in the clinical examination: 28 paraplegics (18 complete, 10 incomplete); and 5 quadriplegics (3 complete and 2 incomplete);

- 14 healthy subjects (control group);

- Average time after injury: 13.5± 7.6 months.

- Clinical examination (Ashworth scale = 1 - 4).

-Ashworth scale;

-Isokinetic dynamometer

Model: Cybex Norm II, Lumex Inc. Ronkomkoma, NY, USA.

-EMG.

- Passive range of motion performed: not referred;

- Angular velocities of passive movement: 15, 30, 60, 90 and 120˚/s;

- Subject position: measurements were done in the sitting position;

- Instructions to subjects: n.d.;

- Number of repetitions: 5 passive articular movements for each angular velocity;

- Spasticity measurement: Determined by recording the 5 negative peak torque values (foot. pounds ? ft.lb) at all speeds and joint movements using, for analysis, the maximum torque peak (mT) and the sum of the 5 torque peak (∑T).

The results showed that the average mT and ∑T values were positively correlated with the Ashworth grades. In knee flexion-extension and ankle dorsal flexion, patients with Ashworth grade one did not differ from control group in their torque values while they differ significantly in hip abduction (P50.05), and in knee flexion-extension, the difference between torque values of patients with Ashworth grade 2 and control group was insignificant. There was no significant linear correlation between torque values and velocity of joint motion in either the patient or the control group.