Correlation of spasticity with hyperactive stretch reflexes and motor dysfunction in hemiplegia.

OBJECTIVES

To study the correlation between spasticity and motor dysfunction in the wrist-hand unit of adult hemiplegic patients, and to investigate the correlation between clinical spasticity and hyperactive stretch reflexes.

STUDY

DESIGN

A survey study with a sequential case series of subjects.

SETTING

Neuromuscular Research Laboratory, School of Physical Therapy, Texas Woman's University, Houston, TX.

SUBJECTS: Sequential sample recruited from local stroke support groups: 10 patients with chronic hemiplegia caused by cerebral vascular accident who had various degrees of spasticity in the wrist joint.

OUTCOME MEASURES: Modified Ashworth Scale, amplitudes of stretch reflexes for wrist flexors, grip strength, active range of motion of the wrist joint, and Fugl-Meyer test.

RESULTS

Strong reverse correlation was found between spasticity and grip strength, the Fugl-Meyer test scores, and the Box and Blocks test scores (p = .001 to .005). Results also indicated a strong and consistent correlation between spasticity and reflexive electromyographic activities of the stretch reflex recorded from active muscles (p = .005 and .007), but not between spasticity and torque response of the stretch reflex.

CONCLUSIONS

The degree of wrist spasticity is associated with impaired hand function in hemiplegic patients, and hyperactive electromyographic response of the stretch reflex, recorded from active muscles, is a valid indicator of spasticity.