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Theoretical and methodological considerations in the measurement of spasticity

Theoretical and methodological considerations in the measurement of spasticity
Theoretical and methodological considerations in the measurement of spasticity
Purpose: To discuss the measurement of spasticity in the clinical and research environments, make recommendations based on the SPASM reviews of biomechanical, neurophysiological and clinical methods of measuring spasticity and indicate future developments of measurement tools. Method: Using the results of the systematic reviews of the biomechanical, neurophysiological and clinical approaches, methods were evaluated across three dimensions: (1) validity, reliability and sensitivity to change (2) practical quality such as ease of use and (3) qualities specific to the measurement of spasticity, for example ability to be applied to different muscle groups. Methods were considered in terms of applicability to research and clinical applications.Results: A hierarchy of measurement approaches was identified from highly controlled and more objective (but unrelated to function) to ecologically valid, but less objective and subject to contamination from other variables. The lack of a precise definition of spasticity may account for the problem of developing a valid, reliable and sensitive method of measurement. The reviews have identified that some tests measure spasticity per se, some phenomena associated with spasticity or consequential to it and others the effect of spasticity on activity and participation and independence.Conclusions: Methods appropriate for use in research, particularly into the mechanism of spasticity did not satisfy the needs of the clinician and the need for an objective but clinically applicable tool was identified. A clinical assessment may need to generate more than one 'value' and should include evaluation of other components of the upper motor neurone syndrome. There is therefore a need for standardized protocols for 'best practice' in application of spasticity measurement tools and scales.
research, methods, quality, assessment, practice
0963-8288
69 - 80
Burridge, J. H.
14987395-63ca-4a32-8504-4078ba1da3f8
Wood, D. E.
20ee09d9-709f-4656-bab4-7807ff8d4d4a
Hermens, H.
d8a583c7-fa26-452d-b12e-c965c6e212cc
Voerman, G. E.
575827ea-95dc-4bee-80ef-f140881f1ae6
Johnson, G. R.
fef55eba-c586-44fb-b1bc-2c91718f15ef
Van Wijck, F.
5a1733ae-ac01-4db1-9b8e-23560c77c412
Platz, T.
8fdce0d0-2896-48da-b4cc-2032d5d5b27f
Gregoric, M.
94c4eedd-8f96-4b64-a471-f9dbf626d603
Hitchcock, R. A. D.
f6da270d-8cce-4f21-8e29-e9cd06b3f8ad
Burridge, J. H.
14987395-63ca-4a32-8504-4078ba1da3f8
Wood, D. E.
20ee09d9-709f-4656-bab4-7807ff8d4d4a
Hermens, H.
d8a583c7-fa26-452d-b12e-c965c6e212cc
Voerman, G. E.
575827ea-95dc-4bee-80ef-f140881f1ae6
Johnson, G. R.
fef55eba-c586-44fb-b1bc-2c91718f15ef
Van Wijck, F.
5a1733ae-ac01-4db1-9b8e-23560c77c412
Platz, T.
8fdce0d0-2896-48da-b4cc-2032d5d5b27f
Gregoric, M.
94c4eedd-8f96-4b64-a471-f9dbf626d603
Hitchcock, R. A. D.
f6da270d-8cce-4f21-8e29-e9cd06b3f8ad

Burridge, J. H., Wood, D. E., Hermens, H., Voerman, G. E., Johnson, G. R., Van Wijck, F., Platz, T., Gregoric, M. and Hitchcock, R. A. D. (2005) Theoretical and methodological considerations in the measurement of spasticity. Disability and Rehabilitation, 27 (1/2), 69 - 80. (doi:10.1080/09638280400014592).

Record type: Article

Abstract

Purpose: To discuss the measurement of spasticity in the clinical and research environments, make recommendations based on the SPASM reviews of biomechanical, neurophysiological and clinical methods of measuring spasticity and indicate future developments of measurement tools. Method: Using the results of the systematic reviews of the biomechanical, neurophysiological and clinical approaches, methods were evaluated across three dimensions: (1) validity, reliability and sensitivity to change (2) practical quality such as ease of use and (3) qualities specific to the measurement of spasticity, for example ability to be applied to different muscle groups. Methods were considered in terms of applicability to research and clinical applications.Results: A hierarchy of measurement approaches was identified from highly controlled and more objective (but unrelated to function) to ecologically valid, but less objective and subject to contamination from other variables. The lack of a precise definition of spasticity may account for the problem of developing a valid, reliable and sensitive method of measurement. The reviews have identified that some tests measure spasticity per se, some phenomena associated with spasticity or consequential to it and others the effect of spasticity on activity and participation and independence.Conclusions: Methods appropriate for use in research, particularly into the mechanism of spasticity did not satisfy the needs of the clinician and the need for an objective but clinically applicable tool was identified. A clinical assessment may need to generate more than one 'value' and should include evaluation of other components of the upper motor neurone syndrome. There is therefore a need for standardized protocols for 'best practice' in application of spasticity measurement tools and scales.

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Published date: 2005
Keywords: research, methods, quality, assessment, practice

Identifiers

Local EPrints ID: 17845
URI: http://eprints.soton.ac.uk/id/eprint/17845
ISSN: 0963-8288
PURE UUID: 92a49415-b7f9-43b4-97a3-8b1913e2edb2

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Date deposited: 27 Oct 2005
Last modified: 15 Jul 2019 19:29

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