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Related Experiment Video

Updated: May 31, 2026

Isokinetic Robotic Device to Improve Test-Retest and Inter-Rater Reliability for Stretch Reflex Measurements in Stroke Patients with Spasticity
08:40

Isokinetic Robotic Device to Improve Test-Retest and Inter-Rater Reliability for Stretch Reflex Measurements in Stroke Patients with Spasticity

Published on: June 12, 2019

Early recognition of post-stroke spasticity: the I-REFER study.

Klemens Fheodoroff1, Benjamin Waeschle2, Manuela Schuetzer3

  • 1KABEG Gailtal-Klinik, Neurorehabilitation, Hermagor, Austria.

Frontiers in Neurology
|May 29, 2026
PubMed
Summary

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Evolution of goal setting and attainment over repeated cycles of botulinum toxin A for upper limb spasticity in real-life clinical practice: longitudinal analyses from the observational ULIS-III cohort study.

Journal of rehabilitation medicine·2026
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Longitudinal, Multi-Cycle Evaluation of Passive Function Improvement in People with Arm Spasticity Treated with Botulinum Toxin A.

Toxins·2026
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A Novel Ultrasound Window for Simultaneous Botulinum Neurotoxin Injection Into Three Deep Leg Muscles in Ankle and Foot Spasticity Patterns.

Cureus·2026
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Establishing levels of arm-hand activities in stroke patients: the arm-hand-activities-scale (AHAS).

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Efficacy and Safety of IncobotulinumtoxinA in Older Patients with Upper Limb Spasticity: A Pooled Analysis.

Geriatrics (Basel, Switzerland)·2025
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Meta-Analysis of Goal Setting and Physical Treatment Categorisation for Focal Spasticity Following Stroke or Other Acquired Brain Injury.

Advances in rehabilitation science and practice·2025

A new decision tree effectively helps nurses and therapists identify post-stroke spasticity (PSS). This tool improves early PSS recognition and referral, leading to timely diagnosis and treatment.

Area of Science:

  • Neurology
  • Rehabilitation Medicine
  • Clinical Assessment Tools

Background:

  • Effective management of post-stroke spasticity (PSS) is hindered by limited access to specialists, leading to underdiagnosis and undertreatment.
  • Empowering non-specialist healthcare professionals, such as nurses and therapists, to identify PSS can expedite appropriate referrals.
  • This study evaluated the validity and inter-rater reliability of a novel decision tree for upper extremity PSS.

Purpose of the Study:

  • To assess the validity and inter-rater reliability (IRR) of the spastic movement disorders decision tree for upper extremity spasticity.
  • To compare referral decisions made by nurses and therapists using the decision tree against those made by specialist physicians.

Main Methods:

  • A decision tree was used by nurses and therapists to evaluate three cardinal symptoms of PSS (elbow, wrist, fingers) as "no/minimal," "moderate," or "severe."
Keywords:
botulinum neurotoxin type A [MeSH term]decision tree [MeSH term]early recognitionmuscle spasticity [MeSH term]nursespost-stroke spasticitystroke [MeSH term]therapists

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Last Updated: May 31, 2026

Isokinetic Robotic Device to Improve Test-Retest and Inter-Rater Reliability for Stretch Reflex Measurements in Stroke Patients with Spasticity
08:40

Isokinetic Robotic Device to Improve Test-Retest and Inter-Rater Reliability for Stretch Reflex Measurements in Stroke Patients with Spasticity

Published on: June 12, 2019

Determining the Functional Status of the Corticospinal Tract Within One Week of Stroke
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Published on: February 22, 2020

  • Referral decisions (n=69) from five nurses and four therapists were compared to specialist physician assessments.
  • Inter-rater reliability (IRR), sensitivity, specificity, and predictive values were calculated.

    • Main Results:

    • High IRR was observed between nurses and physicians for specialist referral decisions (overall 85.5%).
    • The decision tree demonstrated high sensitivity (84.6%) and specificity (86.7%) in identifying patients needing specialist referral.
    • Similar high validity and reliability were found for therapists compared to physicians, with high positive (89.2%) and negative (81.3%) predictive values.

    Conclusions:

    • The spastic movement disorders decision tree is a valid and reliable tool for nurses and therapists to identify potential PSS in the upper extremities.
    • This tool can facilitate early recognition and specialist referral, potentially improving timely diagnosis and treatment, including botulinum toxin type A (BoNT-A).
    • Introduction into standard clinical practice and examination of broader community use are recommended.