Motorized versus manual instrumented spasticity assessment in children with cerebral palsy
- Author
- Lizeth H. Sloot, Lynn Bar-On (UGent) , Marjolein M. van der Krogt, Erwin Aertbelien, Annemieke I. Buizer, Kaat Desloovere and Jaap Harlaar
- Organization
- Abstract
- AimWe compared the outcomes of manual and motorized instrumented ankle spasticity assessments in children with cerebral palsy (CP). MethodTen children with spastic CP (three males, seven females; mean age 11y [standard deviation 3y], range 6-14y; Gross Motor Function Classification System levels I-III) were included. During motorized assessments, fast (100 degrees/s) rotations were imposed around the ankle joint by a motor-driven footplate; during manual assessments, rotations of comparable speed were applied by a therapist using a foot orthotic. Angular range of motion, maximum velocity, acceleration, work, and muscle activity (electromyography [EMG]) of the triceps surae and tibialis anterior were compared during passive muscle stretch between motorized and manual assessments. Both movement profiles were also compared to CP gait ankle movement profile. ResultsThe imposed movement profile differed between methods, with the motorized assessment reaching higher maximum acceleration. Despite equal maximum velocity, the triceps surae were more often activated in motorized assessments, with low agreement of 44% to 72% (0) for EMG onset occurrence between methods. The manually applied ankle velocity profile matched more closely with the gait profile. InterpretationThe differences in acceleration possibly account for the different muscle responses, which may suggest acceleration, rather than velocity-dependency of the stretch reflex. Future prototypes of instrumented spasticity assessments should standardize movement profiles, preferably by developing profiles that mimic functional tasks such as walking.
- Keywords
- HAND-HELD, REFLEX, MOVEMENT, STRETCH, MUSCLES
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Citation
Please use this url to cite or link to this publication: http://hdl.handle.net/1854/LU-8695829
- MLA
- Sloot, Lizeth H., et al. “Motorized versus Manual Instrumented Spasticity Assessment in Children with Cerebral Palsy.” DEVELOPMENTAL MEDICINE AND CHILD NEUROLOGY, vol. 59, no. 2, 2017, pp. 145–51, doi:10.1111/dmcn.13194.
- APA
- Sloot, L. H., Bar-On, L., van der Krogt, M. M., Aertbelien, E., Buizer, A. I., Desloovere, K., & Harlaar, J. (2017). Motorized versus manual instrumented spasticity assessment in children with cerebral palsy. DEVELOPMENTAL MEDICINE AND CHILD NEUROLOGY, 59(2), 145–151. https://doi.org/10.1111/dmcn.13194
- Chicago author-date
- Sloot, Lizeth H., Lynn Bar-On, Marjolein M. van der Krogt, Erwin Aertbelien, Annemieke I. Buizer, Kaat Desloovere, and Jaap Harlaar. 2017. “Motorized versus Manual Instrumented Spasticity Assessment in Children with Cerebral Palsy.” DEVELOPMENTAL MEDICINE AND CHILD NEUROLOGY 59 (2): 145–51. https://doi.org/10.1111/dmcn.13194.
- Chicago author-date (all authors)
- Sloot, Lizeth H., Lynn Bar-On, Marjolein M. van der Krogt, Erwin Aertbelien, Annemieke I. Buizer, Kaat Desloovere, and Jaap Harlaar. 2017. “Motorized versus Manual Instrumented Spasticity Assessment in Children with Cerebral Palsy.” DEVELOPMENTAL MEDICINE AND CHILD NEUROLOGY 59 (2): 145–151. doi:10.1111/dmcn.13194.
- Vancouver
- 1.Sloot LH, Bar-On L, van der Krogt MM, Aertbelien E, Buizer AI, Desloovere K, et al. Motorized versus manual instrumented spasticity assessment in children with cerebral palsy. DEVELOPMENTAL MEDICINE AND CHILD NEUROLOGY. 2017;59(2):145–51.
- IEEE
- [1]L. H. Sloot et al., “Motorized versus manual instrumented spasticity assessment in children with cerebral palsy,” DEVELOPMENTAL MEDICINE AND CHILD NEUROLOGY, vol. 59, no. 2, pp. 145–151, 2017.
@article{8695829,
abstract = {{AimWe compared the outcomes of manual and motorized instrumented ankle spasticity assessments in children with cerebral palsy (CP).
MethodTen children with spastic CP (three males, seven females; mean age 11y [standard deviation 3y], range 6-14y; Gross Motor Function Classification System levels I-III) were included. During motorized assessments, fast (100 degrees/s) rotations were imposed around the ankle joint by a motor-driven footplate; during manual assessments, rotations of comparable speed were applied by a therapist using a foot orthotic. Angular range of motion, maximum velocity, acceleration, work, and muscle activity (electromyography [EMG]) of the triceps surae and tibialis anterior were compared during passive muscle stretch between motorized and manual assessments. Both movement profiles were also compared to CP gait ankle movement profile.
ResultsThe imposed movement profile differed between methods, with the motorized assessment reaching higher maximum acceleration. Despite equal maximum velocity, the triceps surae were more often activated in motorized assessments, with low agreement of 44% to 72% (0) for EMG onset occurrence between methods. The manually applied ankle velocity profile matched more closely with the gait profile.
InterpretationThe differences in acceleration possibly account for the different muscle responses, which may suggest acceleration, rather than velocity-dependency of the stretch reflex. Future prototypes of instrumented spasticity assessments should standardize movement profiles, preferably by developing profiles that mimic functional tasks such as walking.}},
author = {{Sloot, Lizeth H. and Bar-On, Lynn and van der Krogt, Marjolein M. and Aertbelien, Erwin and Buizer, Annemieke I. and Desloovere, Kaat and Harlaar, Jaap}},
issn = {{0012-1622}},
journal = {{DEVELOPMENTAL MEDICINE AND CHILD NEUROLOGY}},
keywords = {{HAND-HELD,REFLEX,MOVEMENT,STRETCH,MUSCLES}},
language = {{eng}},
number = {{2}},
pages = {{145--151}},
title = {{Motorized versus manual instrumented spasticity assessment in children with cerebral palsy}},
url = {{http://doi.org/10.1111/dmcn.13194}},
volume = {{59}},
year = {{2017}},
}
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