Advertisement

Clinical neurophysiological assessment of spasticity

  • J. Zidar
  • M. R. Dimitrijević

Abstract

It is possible to approach the neurophysiological assessment of spasticity in two ways. The most straightforward and simple one is to document clinical phenomena, for example exaggerated tonic and phasic stretch reflexes. The other approach is based on description of the underlying spinal and supraspinal mechanisms of spasticity. Both of them are successful in quantifying spastic phenomena and are therefore useful for assessment of the efficacy of different forms of treatment.

Keywords

Spinal Cord Lesion Presynaptic Inhibition Recurrent Inhibition Passive Stretch Spinal Cord Injured Patient 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Asanuma H (1981) The pyramidal tract. In: Brooks WB (ed) Handbook of physiology. The nervous system, vol 2. Motor control. American Physiological Society, Bethesda, pp 203–233Google Scholar
  2. Ashby P, Verrier M (1975) Neurophysiological changes following spinal cord lesions in man. Can J Neurol Sci 2:91–100PubMedGoogle Scholar
  3. Bajd T, Vodovnik L (1984) Pendulum testing of spasticity. J Biomed Eng 6:9–16PubMedCrossRefGoogle Scholar
  4. Boczko M, Mumenthaler M (1954) Modified pendulousness test to assess tonus of thigh muscles in spasticity. Neurology 8:846–851CrossRefGoogle Scholar
  5. Cioni B, Dimitrijević MR, McKay WB, Sherwood AM (1986) Voluntary supraspinal suppression of spinal reflex activity in paralysed muscles of spinal cord injury patients. Exp Neurol 93:574–583PubMedCrossRefGoogle Scholar
  6. Delwaide PJ (1971) Etude Experimentale de l’Hyperreflexie Tendineuse en Clinique Neurologique. Arschia, Bruxelles, pp 1–324Google Scholar
  7. Delwaide PJ (1973) Human monosynaptic reflexes and presynaptic inhibition. An interpretation of spastic hyperreflexia. In: Desmedt JE (ed) New developments in electromyography and clinical neurophysiology, vol 3. Karger, Basel, pp 508–522Google Scholar
  8. Dimitrijević MR (1985) Spasticity. In: Swash M, Kennard C (eds) Scientific basis of clinical neurology. Churchill Livingstone, New York, pp 108–115Google Scholar
  9. Dimitrijević MR, Nathan P (1967) Studies of spasticity in man. 2. Analysis of stretch reflexes in spasticity. Brain 91:333–358CrossRefGoogle Scholar
  10. Dimitrijević MR, Nathan P (1969) Studies of spasticity in man. 3. Analysis of reflex activity evoked by noxious cutaneous stimulation. Brain 94:17–90Google Scholar
  11. Dimitrijević MR, Spencer WA, Trontelj JV, Dimitrijević MM (1977) Reflex effects of vibration in patients with spinal cord lesions. Neurology 27:1078–1086PubMedCrossRefGoogle Scholar
  12. Dimitrijević MR, Gregoric MR, Sherwood AM, Spencer WA (1980) Reflex responses of paraspinal muscles to tapping. J Neurol Neurosurg Psychiatry 43:1112–1118PubMedCrossRefGoogle Scholar
  13. Dimitrijević MR, Dimitrijević MM, McKay WB, Sherwood AM (1981) Supraspinal influence on motor unit activity in paralysed muscles: effects of reinforcement maneuvers. Arch Phys Med 62:540Google Scholar
  14. Eldred E, Granit R, Merton PA (1953) Supraspinal control of the muscle spindles and its significance. J Physiol (London) 122:498–523Google Scholar
  15. Hagbarth KE, Eklund G (1966) Motor effects of vibratory stimuli in man. In: Granit Nobel Symposium I. Muscle afferents and motor control. Almquist and Wiksell, Stockholm, pp 177–182Google Scholar
  16. Hagbarth KE, Wallin G, Löfstedt L (1973) Muscle spindle responses to stretch in normal and spastic subjects. Scand J Rehab Med 5:156–159Google Scholar
  17. Katz R, Pierrot-Deseilligny E (1982) Recurrent inhibition of alpha-motoneurons in patients with upper motor neuron lesions. Brain 105:103–124PubMedCrossRefGoogle Scholar
  18. Knutsson E, Martensson A (1980) Dynamic motor capacity in spastic paresis and its relation to prime-mover dysfunction, spastic reflexes and antagonistic co-activation. Scand J Rehab Med 12:93–106Google Scholar
  19. Lance JW (1980) Symposium synopsis. In: Feldman RG, Young RR, Koella WP (eds) Spasticity: disordered motor control. Year Book Medical Publishers, Chicago, pp 485–494Google Scholar
  20. Lance JW, Burke D, Andrews CJ (1973) The reflex effects of muscle vibration. In: Desmedt JE (ed) New developments in electromyography and clinical neurophysiology, vol 3. Karger, Basel, pp 444–462Google Scholar
  21. Magoun HW, Rhines R (1947) Spasticity: the stretch-reflex and extrapyramidal systems. Charles C Thomas Publ, Springfield IllinoisGoogle Scholar
  22. Moody JR, Dimitrijević MR (1964) An electromyogrphic study of tendon reflexes in progressive muscular dystrophy in man. Brain 87:511–520PubMedCrossRefGoogle Scholar
  23. Nathan PW (1980) Factors affecting spasticity. Int Rehabil Med 2:27–30PubMedGoogle Scholar
  24. Patton HD, Amassian VE (1960) The pyramidal tract; its excitation and functions. In: Field J (ed) Handbook of physiology and neurophysiology. American Physiological Society, Washington DC, pp 837–861Google Scholar
  25. Phillips CG (1973) Pyramidal apparatus for control of the baboon hand. In: Desmedt JE (ed) New developments in electromyography and clinical neurophysiology, vol 3. Karger, Basel, pp 136–144Google Scholar
  26. Pierrot-Deseilligny E, Bussel B (1975) Evidence for recurrent inhibition by motoneurones in human subjects. Brain Res 88:105–108PubMedCrossRefGoogle Scholar
  27. Pierrot-Deseilligny E, Mazieres L (1985) Spinal mechanisms underlying spasticity. In: Delwaide PJ, Young RR (eds) Clinical neurophysiology in spasticity. Elsevier Science Publishers BV, Amsterdam New York Oxford, pp 63–76Google Scholar
  28. Pierrot-Deseilligny E, Morin C, Bergego C, Tankov N (1981) Pattern of group Ib projections from ankle flexor and extensor muscles in man. Exp Brain Res 42:337–356PubMedGoogle Scholar
  29. Taborikova H, Sax DS (1968) Motoneurone pool and the spinal H-reflex. J Neurol Neurosurg Psychiatry 31:354–361PubMedCrossRefGoogle Scholar
  30. Tanaka R (1974) Reciprocal Ia inhibition during voluntary movement in man. Exp Brain Res 21:529–540PubMedCrossRefGoogle Scholar
  31. Tanaka R (1983) Reciprocal Ia inhibitory pathway in normal man and in patients with motor disorders. In: Desmedt JE (ed) Motor control mechanisms in health and disease. Raven Press, New York, pp 433–441Google Scholar
  32. Toft E, Sinkjaer G, Espersen GT (1989) Quantitation of the stretch reflex. Technical procedures and clinical applications. Acta Neurol Scand 79:384–390PubMedCrossRefGoogle Scholar
  33. VanGijn J (1975) Babinski response: stimulus and effector. J Neurol Neurosurg Psychiatry 38:180–186CrossRefGoogle Scholar
  34. VanGijn J (1976) Equivocal plantar responses: a clinical and electromyographic study. J Neurol Neurosurg Psychiatry 39:275–282CrossRefGoogle Scholar
  35. Wiesendanger M (1981) The pyramidal tract, its structure and function. In: Towe AL, Luschei ES (eds) Handbook of behavioral neurobiology. Plenum Press, New York, pp 401–491Google Scholar

Copyright information

© Springer-Verlag Wien 1991

Authors and Affiliations

  • J. Zidar
    • 1
  • M. R. Dimitrijević
    • 2
  1. 1.Institute of Clinical NeurophysiologyUniversity Medical CenterLjubljanaYugoslavia
  2. 2.Division of Restorative Neurology and Human NeurobiologyBaylor College of MedicineHoustonUSA

Personalised recommendations