Quantitative evaluation of spasticity
PhD thesis by Jakob Lorentzen
2010, 143 pages, DKR 100,-
ISBN: 978 87 917 71 309
Spasticity is a common manifestation of a lesion of the central motor pathways that in some cases interferes with motor function and affects quality of life. Different perceptions of spasticity among clinicians and researchers have led to confusion. Based on results from basic and clinical research, the aim of the work described in this thesis was to contribute to a clearer understanding of the rationale for distinguishing between different features of spasticity and to answer some of the questions related to its quantification.
The first part of the thesis consists of an introduction to the definitions of spasticity followed by a brief historical review of relevant mechanisms involved in spasticity. This section includes the results that focus on measurements of Post Activation Depression (PAD) and the biomechanical reaction to the identified electrophysiological phenomenon.
The second part focuses on the distinction between increased muscle stiffness caused by increased reflex activity (active stiffness) or by stiffness due to arthrogenic and myogenic changes (passive stiffness).
The third part is based on the results of the efficacy of treatments with Neurodynamics and Random Passive Movements (RPM) in relation to stiffness reduction in the knee joint.
The results contribute to a better understanding of the involvement of a spinal mechanism (PAD) in increased resistance to passive movements due to spasticity. The difficulties in clinical distinction between active and passive stiffness were also highlighted by the results of this study. In order to improve the clinical spasticity measurement methods there is need for further development of objective biomechanical clinically applicable methods. This is necessary for evaluation of the efficacy of anti-spastic treatments.
From Jakob Lorentzens PhD defence December 10, 2010
Content (pdf, 75 kb)
Summary (pdf, 89 kb)
Preface (pdf, 70 kb)
List of studies (pdf, 73 kb)