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Updated: Mar 11, 2026

Bilateral Assessment of the Corticospinal Pathways of the Ankle Muscles Using Navigated Transcranial Magnetic Stimulation
Published on: February 19, 2019
Ankle plantarflexor spasticity is not differentially disabling for those who are weak following traumatic brain
Gavin Williams1,2, Megan Banky1, Dean McKenzie3,4
1a Epworth Hospital , Melbourne , Australia.
Primary Objectives:
The main aim of this study was to determine whether the presence of distal lower-limb spasticity had a greater impact on mobility for those who had greater levels of muscle paresis following traumatic brain injury (TBI).
Research Design:
This was a cross-sectional cohort study of convenience. Seventy-five people attending physiotherapy for mobility limitations following TBI participated in this study. All participants had sustained a moderate-severe TBI and were grouped according to the presence or absence of ankle plantarflexor spasticity for comparison.
Main Outcomes And Results:
The primary outcome measure for mobility was self-selected walking speed and the primary outcome measure for muscle strength was hand-held dynamometry. Secondary outcome measures for mobility and muscle strength were the High-level Mobility Assessment Tool (HiMAT) and ankle power generation (APG) at push-off. Spasticity was quantified with the Modified Tardieu scale. Participants with ankle plantarflexor spasticity (Group 2) had slower self-selected walking speeds. There was no statistically significant effect for Group and plantarflexor strength (p = 0.81).
Conclusion:
Although participants with ankle plantarflexor spasticity walked significantly slower than those without, the presence of ankle plantarflexor spasticity did not lead to greater mobility limitations for those who were weak.
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