Clinical application of quantitative methods in the study of spasticity

Abstract

Instrumentation and methods are described for measuring and recording in an eight‐channel system a variety of muscular and electromyographic variables that are regarded as appropriate to the objective study of spasticity and other related neurophysiologic responses. These variables include resistive forces developed in extensor and flexor muscles elicited by passive stretching through the full arc of motion, tensive forces developed in response to tendon tap in eliciting deep muscle myotatic reflexes, and angle of swing in unrestricted responses of the same type. Correlated electromyographic potentials are recorded in both extensor and flexor muscles concurrently with the muscular resistive forces and the angle of motion. A case study is presented to illustrate the sen8itivity and Consistency of the procedures in detecting effects from spasmolytic medication in altering the responses of a patient with clinically evident spasticity. Conclusions are particularized for the individual case presented. Numerous problems, including statistical methods and experimental designs, are being studied with a view toward planning systematic investigation of medication effects in patients with clinical manifestations of hypertonicity and hyperreflexia.