A simple tool to measure spasticity in spinal cord injury subjects

This work presents a wearable device and the algorithms for quantitative modelling of joint spasticity and its application in a pilot group of subjects with different levels of spinal cord injury. The device comprises light-weight instrumented handles to measure the interaction force between the subject and the physical therapist performing the tests, EMG sensors and inertial measurement units to measure muscle activity and joint kinematics. Experimental tests included the passive movement of different body segments, where the spasticity was expected, at different velocities. Tonic stretch reflex thresholds and their velocity modulation factor are computed, as a quantitative index of spasticity, by using the kinematics data at the onset of spasm detected through thresholding the EMG data. This technique was applied to two spinal cord injury subjects. The proposed method allowed the analysis of spasticity at muscle and joint levels. The obtained results are in line with the expert diagnosis and qualitative spasticity characterisation on each individual.

[1]  F. Maynard,et al.  Epidemiology of spasticity following traumatic spinal cord injury. , 1990, Archives of physical medicine and rehabilitation.

[2]  Auke Jan Ijspeert,et al.  Effects of a neuromuscular controller on a powered ankle exoskeleton during human walking , 2016, 2016 6th IEEE International Conference on Biomedical Robotics and Biomechatronics (BioRob).

[3]  A. G. Feldman,et al.  Control of wrist position and muscle relaxation by shifting spatial frames of reference for motoneuronal recruitment: possible involvement of corticospinal pathways , 2010, The Journal of physiology.

[4]  M. Latash Fundamentals of Motor Control , 2012 .

[5]  Anatol G Feldman,et al.  Space and time in the context of equilibrium-point theory. , 2011, Wiley interdisciplinary reviews. Cognitive science.

[6]  M. Levin,et al.  Deficits in the coordination of agonist and antagonist muscles in stroke patients: implications for normal motor control , 2000, Brain Research.

[7]  H Rodgers,et al.  A review of the properties and limitations of the Ashworth and modified Ashworth Scales as measures of spasticity , 1999, Clinical rehabilitation.

[8]  Michael P Barnes,et al.  Are we underestimating the clinical efficacy of botulinum toxin (type A)? Quantifying changes in spasticity, strength and upper limb function after injections of Botox® to the elbow flexors in a unilateral stroke population , 2002, Clinical rehabilitation.

[9]  M. V. von Arbin,et al.  Spasticity After Stroke: Its Occurrence and Association With Motor Impairments and Activity Limitations , 2003, Stroke.

[10]  A. G. Feldman,et al.  Threshold control of motor actions prevents destabilizing effects of proprioceptive delays , 2006, Experimental Brain Research.

[11]  A. G. Feldman,et al.  Stretch reflex spatial threshold measure discriminates between spasticity and rigidity , 2013, Clinical Neurophysiology.