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- Title
VALIDITY, INTRA-RATER RELIABILITY AND NORMATIVE DATA OF THE NEUROFLEXOR™ DEVICE TO MEASURE SPASTICITY OF THE ANKLE PLANTAR FLEXORS AFTER STROKE.
- Authors
PENNATI, Gaia Valentina; CARMENT, Loïc; GODBOLT, Alison K.; PLANTIN, Jeanette; BORG, Jörgen; LINDBERG, Påvel G.
- Abstract
Objective: Quantification of lower limb spasticity after stroke and the differentiation of neural from passive muscle resistance remain key clinical challenges. The aim of this study was to validate the novel NeuroFlexor foot module, to assess the intra-rater reliability of measurements and to identify normative cut-off values. Methods: Fifteen patients with chronic stroke with clinical history of spasticity and 18 healthy subjects were examined with the NeuroFlexor foot module at controlled velocities. Elastic, viscous and neural components of passive dorsiflexion resistance were quantified (in Newton, N). The neural component, reflecting stretch reflex mediated resistance, was validated against electromyography activity. A test-retest design with a 2-way random effects model permitted study of intra-rater reliability. Finally, data from 73 healthy subjects were used to establish cutoff values according to mean + 3 standard deviations and receiver operating characteristic curve analysis. Results: The neural component was higher in stroke patients, increased with stretch velocity and correlated with electromyography amplitude. Reliability was high for the neural component (intraclass correlation coefficient model 2.1 (ICC2,1) ≥ 0.903) and good for the elastic component (ICC2,1 ≥ 0.898). Cutoff values were identified, and all patients with neural component above the limit presented pathological electromyography amplitude (area under the curve (AUC) = 1.00, sensitivity = 100%, specificity = 100%). Conclusion: The NeuroFlexor may offer a clinically feasible and non-invasive way to objectively quantify lower limb spasticity
- Subjects
PILOT projects; STROKE; SKELETAL muscle; RESEARCH evaluation; STATISTICAL reliability; RESEARCH methodology evaluation; RESEARCH methodology; ANTHROPOMETRY; ANKLE; CASE-control method; LEG; SPASTICITY; DESCRIPTIVE statistics; INTRACLASS correlation; STRETCH reflex; PLANTARFLEXION; RECEIVER operating characteristic curves; ELECTROMYOGRAPHY; SENSITIVITY &; specificity (Statistics); DISEASE complications
- Publication
Journal of Rehabilitation Medicine (Stiftelsen Rehabiliteringsinformation), 2023, Vol 55, p1
- ISSN
1650-1977
- Publication type
Article
- DOI
10.2340/jrm.v54.2067