muscle stiffness spasticity
Conditions
Interventions
None listed
Sponsors
Vrije Universiteit Medisch Centrum
Eligibility
Age
2 Years to 99 Years
Inclusion criteria
Inclusion criteria: Clinically established spasticity - Children: GMFCS I-IV - Age: 6-18y for the children - Age: 18-70y for the adults - Able to participate in the experiment for 1.5 hours.
Exclusion criteria
Exclusion criteria: - unable to follow instruction - patients who are already included in any other experimental research study - Concomitant orthopedic disorders such as rheumatoid arthritis, osteoarthritis - Concomitant neurological disorders - Baclofen pump - Change of (spasmolytic) medication in the past 4 weeks
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Five muscle groups of the lower extremities will be tested with ISA: 1) gastrocnemius; 2) soleus; 3) hamstrings; 4) rectus femoris; 5) hip adductors . In addition, two muscle groups of the upper extremities will be tested with ISA: 6) elbow flexors; 7) wrist flexors. Patient positioning and movement direction of slow and fast passive muscle stretch will be based on accepted clinical protocols. In adults, all muscle groups will be tested. The children will be divided in 2 groups (upper and lower extremity testing each maximal two joints) to limit the time of the assessment. Primary outcome parameters measured by ISA are work [J] (area under the power-time curve) and muscle activity (root mean square (RMS) EMG [uV]) for both slow and fast stretch, the determine the non-neura; and neural contribution to hyper-resistance. To test the intra- and inter-rater reliability and measurement precision, intraclass correlation coefficient (ICC), standard error of measurement (SEM) and smallest detectable difference (SDD) will be calculated for each of the outcome parameters. To test validity, the non-neural and neural outcome parameters will be correlated to the SPAT-scores (0-4 for catch), muscle tone (-1,0,1) and Ashworth scale (0-4). | — |
Secondary
| Measure | Time frame |
|---|---|
| Secondary outcome measures are maximal velocity of performance (Vmax [deg/s]), range of motion [deg], and stiffness [Nm/deg] for slow stretches to determine the non-neural contribution. To determine the neural contributions in the fast stretch secondary outcome measures are: maximal velocity of performance (Vmax [deg/s]), joint angle of catch [deg], angle of EMG threshold [deg], and intensity of catch (power [W]; torque times angular velocity). Further secondary outcome parameters are the usability of the instrument (including hard- and software parts) evaluated by a modified version of the System Usability Scale (SUS) and the Quebec User Evaluation of Satisfaction with assistive Technology (QUEST), and the patient-friendliness, evaluated by a modified version of the Orthotics and Prosthetics Users* Survey Satisfaction with Devices and Services (OPUS-SDS) and the QUEST. | — |
Countries
Netherlands
Outcome results
None listed