Spasticity-Approach to the Adult Patient: Clinical, Electrophysiological and Biomechanical Assessment
Spasticity is a serious problem that creates great difficulty for both patients and clinicians. The Support Programme for Assembly of a database for Spasticity Measurement (SPASM) group defined the spasticity as “disordered sensory-motor control, resulting from an upper motor neuron lesion, presenting as intermittent or sustained involuntary activation of muscles”. Spasticity occurs in different types depending on the duration of the lesion present in the central nervous system (acute or slowly emerging), the size of the lesion and the location of the lesion such as cerebral cortex, brain stem or spinal cord. There are three major approaches, clinical, neurophysiological and biomechanical, for assessing spasticity. Although the quantitative measurement of spasticity is fairly difficult, it is obviously important for planning treatment, measuring the response of the patient to the medical and physical therapy and the prediction of prognosis. There is not yet any perfect and effective method for measuring the spasticity. Despite some serious limitations, the Ashworth Scale or the Modified Ashworth Scale continues to be used as the ‘gold standard’.
Keywords : Spasticity, measurement, clinical assessment, isokinetic dynamometry, electrophysiology