Journal
JOURNAL OF REHABILITATION MEDICINE
Volume 53, Issue 1, Pages -Publisher
FOUNDATION REHABILITATION INFORMATION
DOI: 10.2340/16501977-2777
Keywords
muscle spasticity; patient outcome assessment; rehabilitation; brain injuries; gait; walking
Categories
Funding
- Royal Automobile Club of Victoria
- Epworth Research Institute
- Physiotherapy Research Fund
- Australian Government Award
- National Health and Medical Research Council R.D. Wright Biomedical Fellowship [1090415]
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This study found that clinicians often completed the Modified Tardieu Scale too quickly, leading to mismatches with joint angles and angular velocities during walking.
Objective: Spasticity assessment is often used to guide treatment decision-making. Assessment tool limitations may influence the conflicting evidence surrounding the relationship between spasticity and walking. This study investigated whether testing speeds and joint angles during a Modified Tardieu assessment matched lower-limb angular velocity and range of motion during walking. Design: Observational study. Subjects: Thirty-five adults with a neurological condition and 34 assessors. Methods: The Modified Tardieu Scale was completed. Joint angles and peak testing speed during V3 (fast) trials were compared with the same variables during walking in healthy people, at 0.40-0.59, 0.60-0.79 and 1.40-1.60 m/s. The proportion of trials in which the testing speed, start angle, and angle of muscle reaction matched the relevantjoint anglesand angular velocity during walking were analysed. Results: The Modified Tardieu Scale was completed faster than the angular velocities seen during walking in 88.7% (0.40-0.59 m/s), 78.9% (0.60-0.79 m/s) and 56.2% (1.40-1.60 m/s) of trials. When compared with the normative dataset, 4.2%, 9.5% and 13.7% of the trials met all criteria for each respective walking speed. Conclusion: When applied according to the standardized procedure and compared with joint angular velocity during walking, clinicians performed the Modified Tardieu Scale too quickly.
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