Neurology Medical News about spasticity, tonic stretch reflex, Lance’s definition

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Tonic stretch reflex threshold as a measure of spasticity: implications for clinical practice
Topics in Stroke Rehabilitation, 07/30/09

Calota A et al. – A review of clinical and laboratory-based methods to evaluate spasticity defines the condition and introduces a portable device to measure spasticity. The device is based on measurement of the tonic stretch reflex threshold, which is more closely related to Lance’s definition.

Methods

Review of clinical and laboratory-based methods to evaluate spasticity

Results

Lance’s definition of spasticity:
1) excitability of the tonic stretch reflex threshold is the conceptual unit of measure of spasticity
2) because spasticity is a velocity-dependent phenomenon, different velocities of stretch should be used to evaluate spasticity
3) measures should provide insight into role of spasticity in disordered motor control
Lack of consensus on conceptual unit to best capture spasticity
Several biomechanical variables and parameters are often measured alone or in combination without a unifying conceptual framework
Biomechanical issues: stretch reflex gain, stretch reflex threshold, and/or suprathreshold phenomena
Most studies do not link spasticity with other motor deficits and only partly use Lance’s definition tonic stretch reflex threshold as spasticity descriptor
Lambda model offers framework to describe spasticity and presence of disorders in muscle activation

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