Clinical Outcome Assessments for Spasticity: Review, Critique, and Recommendations.

Background: Spasticity is a common feature in patients with disruptions in corticospinal pathways. However, the term is used ambiguously. Here, spasticity is defined as enhanced velocity-dependent stretch reflexes and placed within the context of deforming spastic paresis encompassing other forms of muscle overactivity.

Effects of cardiologic magnetic and optical stimulation on quality of life in patients receiving systemic treatment for cancer: a pilot study.

Background: Oncological systemic treatments such as cytotoxic chemotherapy, radiation therapy or treatment with biological response modifiers can alter the quality of life (QoL) of cancer patients.The aim of this study is to assess the effects of cardiologic magnetic and optical stimulation (CMOS) on QoL in patients with advanced cancer receiving systemic treatment. For this purpose, we designed a non-invasive device that can reproduce and dynamically modulate stimulations of the same nature as the biological electromagnetic emissions specific to the body (cardiac).

Does spastic myopathy determine active movement and ambulation speed in chronic spastic paresis?-A cross-sectional study on plantar flexors.

Background: Functional correlates of spastic myopathy, the muscle disorder of spastic paresis, are unknown.

Objective: To explore reciprocal relationships between clinical and structural parameters of plantar flexors with i) ambulation speed, ii) dorsiflexion and plantarflexion torques in chronic hemiparesis.

Methods: Cross-sectional trial in chronic stroke-induced hemiparesis (>6 months).

Validity and reliability of the chronic composite XA, an upper limb motor assessment using Active Range of Motion in patients with chronic stroke.

Background: Upper limb (UL) spastic paresis has been classically evaluated with assessments of passive movements with limited functional validity. The aim of this study was to assess whether a composite measure of active range of motion (AROM, or XA) is valid and reliable in chronic post-stroke spastic paresis.

Aim: The primary objective was to investigate the validity and reliability of a composite score, comprising multiple XA measurements, to assess UL spastic paresis in patients in chronic stages post-stroke.

Antagonist Activation Measurement in Triceps Surae Using High-Density and Bipolar Surface EMG in Chronic Hemiparesis.

After a stroke, antagonist muscle activation during agonist command impedes movement. This study compared measurements of antagonist muscle activation using surface bipolar EMG in the gastrocnemius medialis (GM) and high-density (HD) EMG in the GM and soleus (SO) during isometric submaximal and maximal dorsiflexion efforts, with knee flexed and extended, in 12 subjects with chronic hemiparesis. The coefficients of antagonist activation (CAN) of GM and SO were calculated according to the ratio of the RMS amplitude during dorsiflexion effort to the maximal agonist effort for the same muscle.

Measurement properties of movement smoothness metrics for upper limb reaching movements in people with moderate to severe subacute stroke.

Background: Movement smoothness is a potential kinematic biomarker of upper extremity (UE) movement quality and recovery after stroke; however, the measurement properties of available smoothness metrics have been poorly assessed in this group. We aimed to measure the reliability, responsiveness and construct validity of several smoothness metrics.

Methods: This ancillary study of the REM-AVC trial included 31 participants with hemiparesis in the subacute phase of stroke (median time since stroke: 38 days).

Serious Game with Electromyography Feedback and Physical Therapy in Young Children with Unilateral Spastic Cerebral Palsy and Equinus Gait: A Prospective Open-Label Study.

The clinical effects of a serious game with electromyography feedback (EMGs_SG) and physical therapy (PT) was investigated prospectively in children with unilateral spastic cerebral palsy (USCP). An additional aim was to better understand the influence of muscle shortening on function. Thirty children with USCP (age 7.

Comparing the Effect of Implanted Peroneal Nerve Stimulation and Ankle-Foot Orthosis on Gait Kinematics in Chronic Hemiparesis: A Randomized Controlled Trial.

Objective: Impaired ankle dorsiflexion in hemiparesis may be treated with ankle-foot orthosis or functional electrical stimulation. Semi-implanted selective functional electrical stimulation uses independent stimulations of deep and superficial peroneal nerves. The aim of this study was to compare gait kinematics using ankle-foot orthosis or semi-implanted selective functional electrical stimulation over 6 months in hemiparesis.

Reliability of the Modified Frenchay Scale for the Assessment of Upper Limb Function in Adults With Hemiparesis.

Objectives: To investigate the reliability of the Modified Frenchay Scale (MFS) in adults with hemiparesis.

Design: Prospective analysis of videos.

Setting: Study conducted in a Neurorehabilitation Unit of a University Hospital.

Guided Self-rehabilitation Contract vs conventional therapy in chronic peripheral facial paresis: VISAGE, a multicenter randomized controlled trial.

Background: One year after persistent peripheral facial paresis (PFP), prescriptions of conventional rehabilitation are often downgraded into maintenance rehabilitation or discontinued, the patient entering what is seen as a chronic stage. This therapeutic choice is not consistent with current knowledge about behavior-induced plasticity, which is available all life long and may allow intense sensorimotor rehabilitation to remain effective. This prospective, randomized, multicenter single-blind study in subjects with chronic unilateral PFP evaluates changes in facial motor function with a Guided Self-rehabilitation Contract (GSC) vs.

Test-Retest and Inter-Rater Reliability of the 20-Meter Ambulation Test in Patients with Parkinson's Disease.

Objective: In patients with Parkinson's disease, limited sit-to-stand, walk and turn contribute to decreased independence and quality of life. The 20-meter Ambulation Test (AT20) evaluates walking a total of 20 m, over a 10-m distance, back and forth between 2 chairs, starting and ending in a seated position. The aim of this study was to evaluate test-retest and inter-rater reliability of the AT20 in patients with Parkinson's disease.

Improved Gait and Radiological Measurements After injection of Botulinum Toxin Into Peroneus Longus in Young Children With USCP and Equinovalgus Gait.

Background: Children with cerebral palsy develop foot deformities due to a combination of factors including muscle shortening, hypertonia, weakness, and cocontraction of muscles acting at the ankle joint resulting in an altered gait pattern. We hypothesized these factors affect the peroneus longus (PL) and tibialis anterior (TA) muscles couple in children who develop equinovalgus gait first followed by planovalgus foot deformities. Our aim was to evaluate the effects of abobotulinum toxin A injection to the PL muscle, in a cohort of children with unilateral spastic cerebral palsy and equinovalgus gait.

Comparison of Various Smoothness Metrics for Upper Limb Movements in Middle-Aged Healthy Subjects.

Backgound: Metrics for movement smoothness include the number of zero-crossings on the acceleration profile (N0C), the log dimensionless jerk (LDLJ), the normalized averaged rectified jerk (NARJ) and the spectral arc length (SPARC). Sensitivity to the handedness and movement type of these four metrics was compared and correlations with other kinematic parameters were explored in healthy subjects.

Methods: Thirty-two healthy participants underwent 3D upper limb motion analysis during two sets of pointing movements on each side.

Using Robot-Based Variables during Upper Limb Robot-Assisted Training in Subacute Stroke Patients to Quantify Treatment Dose.

In post-stroke motor rehabilitation, treatment dose description is estimated approximately. The aim of this retrospective study was to quantify the treatment dose using robot-measured variables during robot-assisted training in patients with subacute stroke. Thirty-six patients performed fifteen 60 min sessions (Session 1−Session 15) of planar, target-directed movements in addition to occupational therapy over 4 (SD 2) weeks.

Do Muscle Changes Contribute to the Neurological Disorder in Spastic Paresis?

Background: At the onset of stroke-induced hemiparesis, muscle tissue is normal and motoneurones are not overactive. Muscle contracture and motoneuronal overactivity then develop. Motor command impairments are classically attributed to the neurological lesion, but the role played by muscle changes has not been investigated.

Three-Dimensional Quantification of Facial Morphology and Movements Using a Wearable Helmet.

This work proposes a 3D normative database of facial ranges of motion in adults free from facial disorders. Ten facial movements were analyzed, each targeting the activity of specific muscle groups innervated by the facial nerve. The experimental protocol included a test-retest reliability positioning procedure of 25 skin markers based on clinical expertise in facial morphology.

Evaluation of the Validity and Reliability of Connected Insoles to Measure Gait Parameters in Healthy Adults.

The continuous, accurate and reliable estimation of gait parameters as a measure of mobility is essential to assess the loss of functional capacity related to the progression of disease. Connected insoles are suitable wearable devices which allow precise, continuous, remote and passive gait assessment. The data of 25 healthy volunteers aged 20 to 77 years were analysed in the study to validate gait parameters (stride length, velocity, stance, swing, step and single support durations and cadence) measured by FeetMe insoles against the GAITRite mat reference.

Agonist and antagonist activation at the ankle monitored along the swing phase in hemiparetic gait.

Background: Descending command in hemiparesis is reduced to agonists and misdirected to antagonists. We monitored agonist and antagonist activation along the swing phase of gait, comparing paretic and non-paretic legs.

Methods: Forty-two adults with chronic hemiparesis underwent gait analysis with bilateral EMG from tibialis anterior, soleus and gastrocnemius medialis.

Quantified clinical measures linked to ambulation speed in hemiparesis.

Background: In spastic paresis, the respective contributions to active function of antagonist hypoextensibility, spasticity, and impaired descending command remain unknown. Objectives: We explored correlations between ambulation speed and coefficients of shortening, spasticity and, weakness for three lower limb extensors.

Methods: This retrospective study identified 140 subjects with chronic hemiparesis (>6 months since injury) assessed during a single visit with barefoot 10-meter ambulation at comfortable and fast speed, and measurements of passive range of motion (X), angle of catch at fast stretch (X) and active range of motion (X) against the resistance of gastrocnemius, rectus femoris, and gluteus maximus.