Abstract
BackgroundSpasticity is a common impairment accompanying stroke. Spasticity of the quadriceps femoris muscle can be quantified using the pendulum test. The measurement properties of pendular kinematics captured using a magnetic tracking system has not been studied among patients who have experienced a stroke. Therefore, this study describes the test-retest reliability and known groups and convergent validity of the pendulum test measures obtained with the Polhemus tracking system.MethodsEight patients with chronic stroke underwent pendulum tests with their affected and unaffected lower limbs, with and without the addition of a 2.2 kg cuff weight at the ankle, using the Polhemus magnetic tracking system. Also measured bilaterally were knee resting angles, Ashworth scores (grades 0–4) of quadriceps femoris muscles, patellar tendon (knee jerk) reflexes (grades 0–4), and isometric knee extension force.ResultsThree measures obtained from pendular traces of the affected side were reliable (intraclass correlation coefficient ≥ .844). Known groups validity was confirmed by demonstration of a significant difference in the measurements between sides. Convergent validity was supported by correlations ≥ .57 between pendulum test measures and other measures reflective of spasticity.ConclusionPendulum test measures obtained with the Polhemus tracking system from the affected side of patients with stroke have good test-retest reliability and both known groups and convergent validity.
Highlights
Controversy surrounds the definition of spasticity, Lance described it as "a motor disorder characterized by a velocity dependent increase in tonic stretch reflexes and increased tendon jerks resulting from disinhibition of the stretch reflex, as one component of the upper motor neuron lesion"[1]
Several tests have been used for quantifying spasticity among patients with diverse sources of upper motor neuron lesions, including stroke, multiple sclerosis, spinal cord injury, and cerebral palsy
We were unable to identify any research that examined the use of magnetic tracking systems during pendulum tests of both lower limbs of patients following stroke
Summary
Controversy surrounds the definition of spasticity, Lance described it as "a motor disorder characterized by a velocity dependent increase in tonic stretch reflexes (muscle tone) and increased tendon jerks resulting from disinhibition of the stretch reflex, as one component of the upper motor neuron lesion"[1]. Several tests have been used for quantifying spasticity among patients with diverse sources of upper motor neuron lesions, including stroke, multiple sclerosis, spinal cord injury, and cerebral palsy. Among such tests, the Ashworth [2] or Modified Ashworth [3] are probably used most often. We were unable to identify any research that examined the use of magnetic tracking systems during pendulum tests of both lower limbs of patients following stroke. Before the pendulum test performed in conjunction with magnetic sensing devices can be recommended for use, it must be shown to have acceptable measurement properties. This study describes the test-retest reliability and known groups and convergent validity of the pendulum test measures obtained with the Polhemus tracking system
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