Measuring resistance to externally induced movement of the wrist joint in chronic stroke patients using an objective hand-held dynamometer

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dc.contributor.authorMahmoud, Wala'
dc.contributor.authorHaugland, Morten
dc.contributor.authorRamos-Murguialday, Ander
dc.contributor.authorHultborn, Hans
dc.contributor.authorZiemann, Ulf
dc.contributor.institutionMedical Technologies
dc.date.accessioned2024-07-24T12:09:58Z
dc.date.available2024-07-24T12:09:58Z
dc.date.issued2023-01
dc.descriptionPublisher Copyright: © 2023 International Federation of Clinical Neurophysiology
dc.description.abstractObjective: We evaluated the resistance to externally induced wrist extension in chronic stroke patients. We aimed to objectively measure and distinguish passive (muscle and soft tissue stiffness) and active (spasticity and spastic dystonia) components of the resistance. Methods: We used a hand-held dynamometer, which measures torque, joint movement and electromyography (EMG) simultaneously, to assess the resistance to externally induced wrist extension. Slow and fast stretches were applied to the affected and unaffected wrists in 57 chronic stroke patients (57 ± 11 years). We extracted from the data parameters that represent passive and muscle activity components and assessed the validity, test–retest reliability and the clinical utility of the measurement. Results: The analysis showed (1) a significant difference in the passive and muscle activity components between the affected and unaffected sides; (2) a significant correlation between passive and muscle activity components and the modified Ashworth scale (MAS); (3) a significant difference between the subgroups of patients stratified by the MAS; (4) an excellent intra-rater reliability on each of the passive and muscle activity components with intra-class coefficients between 0.92 and 0.99; (5) and small measurement error. Conclusions: Using a hand-held dynamometer, we were able to objectively measure the resistance to muscle stretch in the wrist joint in chronic stroke patients and discriminate muscle overactivity components from muscle and soft tissue stiffness. We demonstrated validity, test–retest reliability and the clinical utility of the measurement. Significance: Quantification of the different components of resistance to externally induced movement enables the objective evaluation of neurorehabilitation effects in chronic stroke patients.en
dc.description.sponsorshipWe thank all of the colleagues in the TMS outpatient clinic, particularly Dr. Brigitte Zrenner who was the lead medical doctor of the TMS clinic during the data collection, and Dr. Christoph Zrenner who supported the project and managed the acquisition of the device. We are grateful to all our patients and their families for participating and showing interest in research. We thank Prof. Jens Bo Nielsen for reading and commenting on the manuscript. The Network for European Neuroscience School (NENS) exchange program, enabled a fruitful scientific exchange between the research group in Tübingen and the Nielsen's Lab in Copenhagen. W.M conceived of the study, carried out the experiments and wrote the manuscript. M.H designed the orthosis, and improved the analysis software, U.Z guided the study, U.Z, A.R, and H.H provided critical feedback and helped shape the research, analysis and manuscript. The German Academic Exchange Service (DAAD) provided funding for WM. The Elsass foundation partly funded MH during the optimization of the signal analysis. None of the funding parties had any role in the study design, data collection and analysis, interpretation of the findings, or writing and submission of the manuscript. The German Academic Exchange Service (DAAD) provided funding for WM. The Elsass foundation partly funded MH during the optimization of the signal analysis. None of the funding parties had any role in the study design, data collection and analysis, interpretation of the findings, or writing and submission of the manuscript.
dc.description.statusPeer reviewed
dc.format.extent14
dc.identifier.citationMahmoud , W , Haugland , M , Ramos-Murguialday , A , Hultborn , H & Ziemann , U 2023 , ' Measuring resistance to externally induced movement of the wrist joint in chronic stroke patients using an objective hand-held dynamometer ' , Clinical Neurophysiology Practice , vol. 8 , pp. 97-110 . https://doi.org/10.1016/j.cnp.2023.05.001
dc.identifier.doi10.1016/j.cnp.2023.05.001
dc.identifier.issn2467-981X
dc.identifier.urihttps://hdl.handle.net/11556/4030
dc.identifier.urlhttp://www.scopus.com/inward/record.url?scp=85160577797&partnerID=8YFLogxK
dc.language.isoeng
dc.relation.ispartofClinical Neurophysiology Practice
dc.relation.projectIDElsass foundation partly funded MH
dc.relation.projectIDNENS
dc.relation.projectIDNetwork for European Neuroscience School
dc.relation.projectIDNielsen's Lab
dc.relation.projectIDDeutscher Akademischer Austauschdienst, DAAD
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subject.keywordsMuscle stiffness
dc.subject.keywordsSpastic stroke
dc.subject.keywordsSpasticity
dc.subject.keywordsSpasticity measurement
dc.subject.keywordsNeurology
dc.subject.keywordsNeurology (clinical)
dc.subject.keywordsPhysiology (medical)
dc.subject.keywordsSDG 3 - Good Health and Well-being
dc.titleMeasuring resistance to externally induced movement of the wrist joint in chronic stroke patients using an objective hand-held dynamometeren
dc.typejournal article
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