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Journal of the Korean Academy of Rehabilitation Medicine 1999;23(3):601-608.
An Evaluation of Spasticity Using Pendulum Test and Dynamic Electromyography.
Lee, Eun Woo , Cho, Kang Hee , Kim, Bong Ok
Department of Rehabilitation Medicine, Chungnam National University, College of Medicine.
진자검사와 동적근전도를 이용한 경직 평가
이은우, 조강희, 김봉옥
충남대학교 의과대학 재활의학교실
Abstract

Objective
The aim of this study was to develop objective evaluation method which reflect the velocity dependent increase of stretch reflex in spasticity using the pendulum test and dynamic electromyography.


Method
Kinematic analysis for knee angle and angular velocity measurement, and dynamic electromyography were performed simultaneously during pendulum movement of spastic lower extremity in supine position for nineteen spastic hemiplegia patients and ten normal control subjects. Angular relaxation index (ARI), Maximum angular velocity (MAV), Angular threshold (AT) and Angular velocity threshold (AVT) were used for the evaluation of spsticity.


Results
1) ARI was 1.64⁑0.04 in normal, 1.28⁑0.14 in modified Ashworth scale (MAS) I, 1.18⁑0.16 in MAS II, 1.02⁑0.13 in MAS III, 2) MAV was 325.0⁑29.4 in normal, 301.7⁑37.8 in MAS I, 269.2⁑29.7 in MAS II, 232.4⁑28.2 in MAS III, 3) In normal subjects EMG activity did not occur, whereas in spastic hemiplegic patient a stretch reflex appears in thigh muscle. AT and AVT were 57.39⁑4.45, 256.24⁑14.07 in MAS I, 38.59⁑4.26, 184.45⁑12.7 in MAS II, 19.13⁑7.13, 136.06⁑12.88 in MAS III, respectively, 4) Correlation coefficients of the ARI (r=⁣0.786), AT (r=⁣0.960), AVT (r=⁣0.949) showed significantly negative correlations with the MAS.


Conclusion
1) AT and AVT are more sensitive parameters than ARI for documenting spasticity in hemiplegic patients. 2) An evaluation of spasticity using pendulum test and dynamic electromyography would provide consistent results with little error and would not be influenced by the change of examiner or environment. Thus we can get very reliable results using this method.

Key Words: Spasticity, Hemiplegia, Stretch reflex, Pendulum test, Dynamic EMG


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