Pendulum test in chronic hemiplegic stroke population: additional ambulatory information beyond spasticity

Area of Science:

• Neurorehabilitation
• Biomechanics
• Clinical Assessment

Background:

• Spasticity assessment in stroke survivors often relies on manual tests like the Modified Ashworth Scale (MAS), which may not fully capture functional mobility.
• There is a need for objective measures to complement existing clinical assessments for stroke-related mobility impairments.

Purpose of the Study:

• To investigate the additional ambulatory information provided by the pendulum test in chronic stroke survivors.
• To explore the correlations between pendulum test parameters and established clinical mobility and spasticity assessments.

Main Methods:

• Forty ambulant chronic stroke patients were assessed using clinical evaluations including Brünnstrom recovery stage, manual muscle test, MAS, Tinetti test (TT), Timed up and go test, 10-m walk test (10-MWT), and Barthel index.
• Pendular parameters, specifically first swing excursion (FSE) and relaxation index (RI), were measured using an electrogoniometer.
• Spearman and Pearson partial correlation analyses were performed, controlling for motor recovery (Brünnstrom recovery stage).

Main Results:

• After adjusting for motor recovery, MAS for paretic knee extensors negatively correlated with TT gait scores (r = -0.355, p = 0.027).
• FSE positively correlated with TT balance scores (r = 0.378, p = 0.018).
• RI was associated with comfortable walking speed in the 10-MWT (r = 0.367, p = 0.022).

Conclusions:

• Reduced knee extensor spasticity is linked to improved gait and balance in chronic stroke patients.
• Pendulum test parameters provide supplementary ambulatory data beyond the MAS.
• The pendulum test shows potential as a tool for patient selection and outcome evaluation in stroke spasticity management.