Annals of Rehabilitation Medicine

"Ashworth scale"

Original Articles

The Effect of High Frequency Repetitive Transcranial Magnetic Stimulation on the Motor Function in Post-Stroke Patients.: Sohn, Min Kyun , Kim, Bong Ok , Kim, Sung Gyum , Choi, Pil Soon , Hwang, Sun Hong; J Korean Acad Rehabil Med 2010;34(2):168-173.

Abstract
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Objective
To evaluate the effects of high frequency repetitive transcranial magnetic stimulation (rTMS) of the affected hemisphere on the motor recovery and spasticity in chronic post-stroke hemiplegic patients. Method: Thirteen chronic stroke hemiplegic patients were randomized to receive real and sham rTMS. rTMS was carried out 10 times at a frequency of 10 Hz with 10 s stimulation followed by 50 s rest, totalling 1,000 stimulations to the affected primary motor cortex using an intensity of 100% of resting motor threshold of unaffected hemisphere. Median nerve H-reflex, modified Ashworth scale (MAS) at elbow and wrist, and manual function test (MFT) were measured at baseline and after 2 weeks of treatment. Results: High frequency rTMS resulted in increased H- reflex latency and decreased H-reflex amplitude and H/M ratio. Also MAS decreased and MFT score increased after 2 weeks of treatment. Conclusion: High frequency rTMS in the affected motor cortex might facilitate motor recovery and reduce spasticity in chronic stroke patients. (J Korean Acad Rehab Med 2010; 34: 168-173)

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The Quantitative Measurement of Spasticity Using Change of Muscle Length during Pendulum Test.: Cho, Kang Hee , Chae, Jin Mok , Seo, Jeong Su , Kim, Tae Min , Kim, Bong Ok , Lim, Hyun Kyoon , Lee, Young Shin; J Korean Acad Rehabil Med 2000;24(4):637-644.

Abstract
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Objective: The aim of this study was to develop objective evaluation method of spasticity which reflects the characteristics of lengthening velocity-dependent stretch reflex of spasticity.

Method: Kinematic analysis for knee angle and rectus femoris muscle lengthening parameters, and dynamic EMG were performed simultaneously during pendular movement of spastic lower leg for thirty two patients with spasticity and ten normal control subjects. Angular parameters consist of angular relaxation index (ARI), maximal angular velocity (MAV), angular threshold (AT) and angular velocity threshold (AVT). And lengthening parameters consist of lengthening relaxation index (LRI), maximal lengthening velocity (MLV), lengthening threshold (LT) and lengthening velocity threshold (LVT).

Results: 1) ARI, MAV, AT, and AVT according to Modified Ashworth scale (MAS) were 1.32⁑0.11, 303.84⁑45.11 deg/sec, 44.19⁑13.81 deg, 262.15⁑33.54 deg/sec in MAS I, 1.16⁑0.16, 279.92⁑42.94 deg/sec, 30.33⁑6.02 deg, 247.65⁑35.92 deg/sec in MAS II, and 0.95⁑0.14, 241.31⁑19.98 deg/sec, 20.55⁑2.68 deg, 209.11⁑48.11 deg/sec in MAS III (P＜0.05). 2) LRI, MLV, LT, and LVT according to MAS were 1.27⁑0.11, 0.58⁑0.07, 1.164⁑0.14, 0.53⁑0.05 in MAS I, 1.12⁑0.09, 0.53⁑0.05, 1.150⁑0.08, 0.42⁑0.04 in MAS II, and 0.99⁑0.10, 0.44⁑0.01, 1.137⁑0.15, 0.36⁑0.02 in MAS III (P＜0.05). 3) There were significant correlation between various pendulum test parameters and MAS.

Conclusion: Muscle lengthening parameters as well as knee angular parameters were sensitive parameters reflecting the degree of spasticity. LVT is the most sensitive parameter among all parameters (p＜0.01).