Evaluation of Hand Strength and Spasticity in Hemiplegic Patients
Neurological RehabilitationStroke1 moreThe aim in this study is to evaluate spasticity and hand grip strength with a finger hand robot in the Turkish population.
To Document the Effectiveness of BoNT-A Injection in Adult Subjects With Upper Limb Spasticity Following...
Muscle SpasticityThe purpose of the study is to assess the responder rate as defined by the achievement of the primary goal from the Goal Attainment Scale following one BoNT-A injection cycle in accordance with routine practices.
Prevalence of Spasticity in Veterans Living in a Long-term Care Facility
SpasticityThe purpose of the study is to conduct a feasibility survey of the prevalence of spasticity at a single long-term care facility for veterans and their spouses in Murfreesboro, Tennessee. These data will be used to strengthen a future grant application to the Department of Defense in response to their ongoing Traumatic Brain Injury initiative.
Power Wheelchair Joystick Use in Spastic Cerebral Palsy
Cerebral PalsySpasticityThere are over 750,000 individuals in the U.S. with Cerebral Palsy (CP). Up to 46% of adults with CP report limited mobility in their communities. However, upper limb spasticity and problems with movement can make the independent use of a wheelchair difficult. Forty percent of individuals who desire mobility via electric wheelchairs are precluded from using them because of problems with upper limb function. No studies to date have produced devices that definitively improve mobility for these individuals. We will recruit 22 subjects with Spastic CP and 22 age and gender matched control subjects without apparent disability from advertisements, mailings, and outpatient clinics. Both a conventional joystick (MSJ) and a novel joystick that is customized for each subject will each be used six different computer screen tasks that simulate driving a wheelchair on a path. We will compare subjects and joysticks based on driving performance. Understanding problems with driving will help us to design joysticks and other assistive devices, not only for CP but for Traumatic Brain Injury, Spinal Cord Injury, Parkinson's Disease, stroke, or a variety of other disabilities.
Sit to Stand Movement in Children With Cerebral Palsy
Cerebral PalsySpastic3 moreThe aim of this study is to examine the relationship between trunk control and lower extremity selective motor control during the movement of sit to stand (STS) in children with cerebral palsy (CP).
Using Shear Wave Ultrasound Elastography for Follow up After Anti-spastic Intervention Among Stroke...
StrokeSpasticity4 moreSpasticity of stroke patient, a very common complication in clinical practice, affects performance of hand function and gait pattern. It also interferes with quality of life of patients severely. Currently first line clinical approach to spasticity consist of physical therapy and pharmacological management. However, there are still some refractory cases that needed local intervention such as Botox injection. So far, we only can use subjective methods to measure muscle tension, such as modified Ashworth scale and Tone Assessment Scale. In our previous study, we found that ultrasound shear wave image could correlate with muscle stiffness caused by poststroke spasticity. With this new method, we aim to establish a more objective method in measuring abnormal poststroke muscle tension before and after treatments and further monitor therapeutic effect. We also include several assessment scales to evaluate the correlation between measured muscle spasm and activity of daily living. We hypothesize that the rheological changes in muscles muscle spasm after Botox injection can be detected by ultrasound shear wave image. Therapeutic effect can also be seen in its effect on daily functions. In this project, we will use shear wave imaging of ultrasound to investigate the elasticity (and hardness) of the biceps brachii and brachialis muscle in stroke patients with unilateral hemiplegia before and after Botox injection. The findings of this project will provide the objective evaluation of muscle spasticity and its correlation with functional status, which will provide new points of view toward treatment of spasticity.
Home Based Electrical Stimulation on Post-stroke Lower Limb Tightness.
Spasticity as Sequela of StrokeSpasticity is a common complication post stroke. Post-stroke spasticity along with weakness and lack of coordination result in gait abnormalities and functional limitations. Recent treatment option include neuromuscular electric stimulation (NMES), a form of therapy that applies electrical currents to produce contraction of innervated muscle by depolarizing local motor nerves. Currently, there are wide varieties of NMES devices available commercially for consumer. The main purpose of this study is to evaluate the feasibility and acceptability of a home-based NMES program on lower limb spasticity in patient with post-stroke more than 6 months and to assess the impact of the program. This is single arm prospective intervention study. Patient will apply home-based NMES on their leg for 20 minutes, 5 days a week for 4 weeks. At the end of the study, an outcome measures will be assessed and patient will be required to answer a questionnaires on their experience.
Quantifying Muscle Tone in Patients With Brain Injury - a Feasibility Study
Treatment OutcomeMuscle Dystonia5 moreThis project will determine the feasibility and validity of measuring elbow muscle flexor stiffness in a population of patients with sub-acute severe acquired brain injury using two measurement methods, the portable spasticity assessment device (PSAD) (Movotec, Charlottenlund, Denmark) and an ultrasound measurement called shear wave sonoelastography (SWE).
CLINICAL EFFECT OF BOTULINUM TOXIN TYPE A IN TREATMENT OF SPASTICITY
SpasticityBrain Injuries2 moreSpasticity has been defined as a disorder of the sensorimotor system characterized by a velocity-dependent increase in tonic stretch reflexes (muscle tone) with exaggerated tendon jerks, resulting from hyperexcitability of the stretch reflex. The treatment goal of spasticity is Medical treatment generally combines physiotherapy with medications, depending on spasticity distribution. Systemic treatments such as oral or intrathecal baclofen are generally considered in case of generalized spasticity, whereas local treatments are considered in case of focal spasticity. Local treatments such as Botulinum Toxin type A, phenol, and alcohol present several advantages, allowing to treat of selected muscles without the risk of sedation. As stated above, they are indicated for focal spasticity but might be helpful even in the presence of generalized spasticity with identified focal goals (Bethoux et al., 2015). In particular, Botulinum Toxin type A (BoNT-A) is considered the gold standard treatment for focal spasticity, showing a level A evidence for spasticity reduction in upper- and lower-limb spasticity (Simpson et al., 2016). However, current evidence is mainly focused on post-stroke spasticity (Franceschini et al., 2014), whereas it is still limited in spasticity as a consequence of other aetiologies, such as spinal cord injury (SCI), traumatic brain injury (TBI), or multiple sclerosis (MS). Interestingly, spasticity is a major concern for the rehabilitation of these patients. The aim of this observational study is the evaluation of the clinical efficacy of BoNT-A in spasticity reduction in patients affected by neurological conditions different from post-stroke spasticity, such as SCI, TBI, and MS.
The Efficacy of Botulinum Toxin in Spastic Neuropathic Bladder
Spastic Neurogenic BladderTo assess the efficacy of botulinum toxin in spastic neurogenic bladder.