4.4 Article

Association of Lower Limb Focal Spasticity With Kinematic Variables During Walking in Traumatic Brain Injury

Journal

JOURNAL OF NEUROLOGIC PHYSICAL THERAPY
Volume 46, Issue 3, Pages 213-218

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/NPT.0000000000000400

Keywords

gait; kinematics; spasticity; traumatic brain injury

Funding

  1. Victorian Neurotrauma Initiative (VNI)
  2. Royal Automobile Club Victoria (RACV)

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The relationship between focal muscle spasticity and kinematics of walking in traumatic brain injury patients was examined. It was found that focal muscle spasticity had little relationship with kinematic variables and walking speed in this cohort of people with TBI who could walk without assistance.
Background and Purpose: Focal muscle spasticity is defined as spasticity that affects a localized group of muscles. It is prevalent in many adult-onset neurological conditions, yet the relationship of focal muscle spasticity with walking remains unclear. Therefore, the aim of this study was to determine the relationship of focal muscle spasticity with the kinematics of walking in traumatic brain injury (TBI). Methods: Ninety-one participants with TBI underwent clinical gait analysis and assessment of focal lower limb muscle spasticity in a prospective cross-sectional study. A matched group of 25 healthy controls (HCs) were recruited to establish a reference dataset. Kinematic data for each person with and without focal muscle spasticity following TBI were compared with the HC cohort at a matched walking speed. Results: The TBI and HC cohorts were well matched. Only those with focal hamstring muscle spasticity walked significantly different to those without. They had significantly greater knee flexion (23.4 degrees compared with 10.5 degrees, P < 0.01) at initial contact. There were no other significant differences in kinematic variables between those with and without focal muscle spasticity. There was no significant association between focal muscle spasticity and walking speed. Discussion and Conclusions: Focal muscle spasticity and abnormal kinematics whilst walking were common in this cohort of people with TBI. However, focal muscle spasticity had little relationship with kinematic variables, and no significant relationship with walking speed. This finding has implications for the treatment of focal muscle spasticity to improve walking following TBI. Focal muscle spasticity had little relationship with kinematic variables and walking speed in this cohort of people with TBI who could walk without assistance.

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