Abstract
Background and ObjectiveThe NeuroFlexor is a novel instrument for quantification of neural, viscous and elastic components of passive movement resistance. The aim of this study was to provide normative data and cut-off values from healthy subjects and to use these to explore signs of spasticity at the wrist and fingers in patients recovering from stroke.Methods107 healthy subjects (age range 28–68 years; 51 % females) and 39 stroke patients (age range 33–69 years; 33 % females), 2–4 weeks after stroke, were assessed with the NeuroFlexor. Cut-off values based on mean + 3SD of the reference data were calculated. In patients, the modified Ashworth scale (MAS) was also applied.ResultsIn healthy subjects, neural component was 0.8 ± 0.9 N (mean ± SD), elastic component was 2.7 ± 1.1 N, viscous component was 0.3 ± 0.3 N and resting tension was 5.9 ± 1 N. Age only correlated with elastic component (r = −0.3, p = 0.01). Elasticity and resting tension were higher in males compared to females (p = 0.001) and both correlated positively with height (p = 0.01). Values above healthy population cut-off were observed in 16 patients (41 %) for neural component, in 2 (5 %) for elastic component and in 23 (59 %) for viscous component. Neural component above cut-off did not correspond well to MAS ratings. Ten patients with MAS = 0 had neural component values above cut-off and five patients with MAS ≥ 1 had neural component within normal range.ConclusionThis study provides NeuroFlexor cut-off values that are useful for detection of spasticity in the early phase after stroke.
Highlights
Background and ObjectiveThe NeuroFlexor is a novel instrument for quantification of neural, viscous and elastic components of passive movement resistance
Normative data and cut-off values NeuroFlexor recordings were similar across healthy subjects leading to small variations in components (Fig. 2)
Elastic Component (EC) and resting tension were higher in males compared to females (F = 12, p = 0.001 and F = 12.8, p = 0.001, respectively)
Summary
Background and ObjectiveThe NeuroFlexor is a novel instrument for quantification of neural, viscous and elastic components of passive movement resistance. The prevalence of spasticity is 20–25 % after first-ever stroke, as assessed with conventional clinical evaluation methods such as the modified Ashworth. The MAS is a subjective scale with limited validity and reliability [12,13,14] Another limitation is that the MAS does not allow separate measurement of neural (reflex) and non-neural (muscle and connective tissue) contributions to resistance to passive stretch. Other clinical methods, such as the REPAS [15] and the Tardieu scale [16] may enhance the diagnostic accuracy but do not objectively quantify spasticity. There is a generally recognized need for new and easy to use methods that enable more accurate and reliable evaluation of spasticity and which can help optimize choice and timing of treatments [17]
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