Influence of posture and muscle length on stretch reflex activity in poststroke patients with spasticity

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Fleuren, Judith F. and Nederhand, Mark J. and Hermens, Hermie J. (2006) Influence of posture and muscle length on stretch reflex activity in poststroke patients with spasticity. Archives of Physical Medicine and Rehabilitation, 87 (7). pp. 981-988. ISSN 0003-9993

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Abstract:Objective: To investigate the influence of different positions
on stretch reflex activity of knee flexors and extensors measured
by electromyography in poststroke patients with spasticity
and its expression in the Ashworth Scale. -
Design: Crossover trial with randomized order of positioning.
Setting: Outpatient rehabilitation center in the Netherlands.
Participants: Poststroke patients (N�19) with lower-limb
spasticity. -
Intervention: Changing position: sitting versus supine.
Main Outcome Measures: Root mean square (RMS) values
of muscle activity and goniometric parameters, obtained during
the pendulum test and passive knee flexion and extension, and
Ashworth scores. -
Results: RMS values of bursts of rectus femoris activity
were significantly higher in the supine compared with the
sitting position (P�.006). The first burst of vastus lateralis
activity during the pendulum test (P�.049) and semitendinous
activity during passive stretch (P�.017) were both significantly
higher in the supine versus the sitting position. For both
the pendulum test and passive movement test, the duration and
amplitude of the cyclic movement of the lower leg changed
significantly as well. In the supine position, we found significantly
higher Ashworth scores for the extensors (P=.001) and
lower scores for the flexors (P=.002). -
Conclusions: The outcome of clinical and neurophysiologic
assessment of spasticity is influenced considerably by subject
positioning
Item Type:Article
Copyright:© 2006 Elsevier
Faculty:
Electrical Engineering, Mathematics and Computer Science (EEMCS)
Research Group:
Link to this item:http://purl.utwente.nl/publications/63713
Official URL:http://dx.doi.org/10.1016/j.apmr.2006.03.018
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