By Edward F. Goljan MD, Karlis I. Sloka DO
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Additional info for Rapid Review Laboratory Testing in Clinical Medicine
A cumulative Ashworth score can also be calculated, and is the sum of individual scores for flexion and extension at major joints of each extremity. A score can be calculated for each limb, or a combination of limbs. Although the Ashworth scale is easy to obtain in a clinical setting, it is subjective and more or less dependent on the evaluator. Also, increased resistance to passive movement can be reflex-mediated (reflex hyperexcitability) and/or nonreflex-mediated (soft-tissue resistance). These are not differentiated by the Ashworth scale, but this is an important issue, because different causes of increased resistance may require different treatments.
And Young, R. ), Elsevier Science Publishers BV, The Netherlands. 53. Fung, J. and Barbeau, H. (1989) A dynamic EMG profile index to quantify muscular activation disorder in spastic paretic gait. Electroencephalogr. Clin. Neurophysiol. 73, 233–244. 54. Sutherland, D. H. (1978) Gait analysis in cerebral palsy. Dev. Med. Child Neurol. 20, 807–813. 55. Shapiro, A. et al. (1990) Preoperative and postoperative gait evaluation in cerebral palsy. Arch. Phys. Med. Rehabil. 71, 236–240. 56. Delwaide, P.
Spasticity should be differentiated from rigidity, but as previously mentioned, the two may co-exist. In persons with spasticity, there is usually a difference between resistance in one direction of movement as compared to the opposite direction. In addition, when a joint is moved rapidly, a “spastic catch” owing to activation of the phasic-stretch reflex is often felt. Some persons with spasticity exhibit the “clasped knife” phenomenon, where resistance is perceived through most of passive range of motion, but a sudden “release” is felt towards the end of range.