Evaluation of reflex- and nonreflex-induced muscle resistance to stretch in adults with spinal cord injury using hand-held and isokinetic dynamometry.

Abstract

In this study, we compared the intertrial reliability of resistive torque measurements obtained with hand-held and isokinetic dynamometers and examined the validity of the hand-held dynamometers for the assessment of spastic hypertonia, defined as reflex- and nonreflex-induced resistance to stretch. Nine subjects (mean age = 40.6 years) with a chronic (1-5 years) spinal cord injury participated. The plantar flexors were stretched at 5 degrees /s (low velocity [LV]) and 180 degrees /s (high velocity [HV]) with an isokinetic dynamometer while the evaluator attempted to match these velocities with a hand-held dynamometer. Electromyographic activity of the soleus and tibialis anterior muscles as well as ankle displacements were recorded. Resistive torque and velocity, measured at -5 degrees of dorsiflexion, were averaged (n = 4). High intraclass correlation coefficients (ICCs) were found at LV and HV for both the hand-held (ICC = .93 and .84) and isokinetic (ICC = .99 and .93) dynamometers. With the hand-held dynamometer, lower resistive torques were found at LV (0.8 N.m) and HV (1.2 N.m), whereas higher velocities were attained at HV. The results indicate that the reproducibility of resistive torques obtained with hand-held dynamometry compares with that obtained with isokinetic dynamometry and allows testing of velocities that can be adjusted to the specific level of resistance to stretch. Electromyography confirmed the validity of hand-held dynamometry for assessing reflex and nonreflex components of SH. [Lamontagne A, Malouin F, Richards CL, Dumas F. Evaluation of reflex- and nonreflex-induced muscle resistance to stretch in adults with spinal cord injury using hand-held and isokinetic dynamometry.