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Correlation of spasticity with hyperactive stretch reflexes and motor dysfunction in hemiplegia
Objectives:
To study the correlation between spasticity and motor dysfunction in the wrist-hand unit of adult hemiplegic patients, and to investigate the correlation between clinical spasticity and hyperactive stretch reflexes.
Study Design:
A survey study with a sequential case series of subjects.
Setting:
Neuromuscular Research Laboratory, School of Physical Therapy, Texas Woman's University, Houston, TX.
Subjects:
Sequential sample recruited from local stroke support groups: 10 patients with chronic hemiplegia caused by cerebral vascular accident who had various degrees of spasticity in the wrist joint.
Outcome Measures:
Modified Ashworth Scale, amplitudes of stretch reflexes for wrist flexors, grip strength, active range of motion of the wrist joint, and Fugl-Meyer test.
Results:
Strong reverse correlation was found between spasticity and grip strength, the Fugl-Meyer test scores, and the Box and Blocks test scores (p = .001 to .005). Results also indicated a strong and consistent correlation between spasticity and reflexive electromyographic activities of the stretch reflex recorded from active muscles (p = .005 and .007), but not between spasticity and torque response of the stretch reflex.
Conclusions:
The degree of wrist spasticity is associated with impaired hand function in hemiplegic patients, and hyperactive electromyographic response of the stretch reflex, recorded from active muscles, is a valid indicator of spasticity.