Clinical Measurement of Limb Spasticity in Adults: State of the Science
Clinical Measurement of Limb Spasticity in Adults: State of the Science
复制标题
DOI：
10.1097/jnn.0b013e31820b5f9f
复制
发表时间：
2011-04-01
影响因子：
2.3
通讯作者：
Stoddard, Sarah A.
中科院分区：
文献类型：
--
作者：
Bhimani, Rozina H.;Anderson, Lisa C.;Stoddard, Sarah A.
痉挛是一种神经肌肉功能障碍，其特征是肌肉紧张或僵硬。痉挛发生在上运动神经元疾病的各个方面，并使受影响者的病程和生活质量复杂化。准确和精确的痉挛评估是为患者提供安全有效的痉挛治疗方法的第一步。在临床实践中，检查者评估（Ashworth量表、改良Ashworth量表和视觉模拟量表）和患者自我报告（视觉模拟量表和数字评定量表）用于评估痉挛状态。我们回顾了痉挛的生物学，并总结了在各种上运动神经元疾病中使用临床量表评估评分属性的研究。痉挛的定义是不一致的。评定者的可靠性或临床量表的一致性差异很大。与肌电图结果的一致性好坏参半。患者报告和检查者评估存在差异。来自临床量表的评分是有反应的（在开始治疗后降低，具有已知的有效性），但评分用于索引与上运动神经元疾病自然史相关的个体变化的效用尚不清楚。未来的研究结合病人的报告和检查结果随着时间的推移将有助于澄清痉挛的定义和捕捉的本质。
Spasticity is a neuromuscular dysfunction characterized by tight or stiff muscles. Spasticity occurs across the spectrum of upper motor neuron disease and complicates the course and quality of life of those affected. Accurate and precise assessment of spasticity is the first step in providing safe and effective treatments to patients for management of spasticity. Examiner evaluations (Ashworth Scale, Modified Ashworth, and Visual Analog Scale) and patient self-reports (Visual Analog Scale and Numeric Rating Scale) are used to assess spasticity in clinical practice. We reviewed the biology of spasticity and summarized research that assessed properties of scores obtained from clinical scales when used in a variety of upper motor neuron diseases. The definition of spasticity was inconsistent. Rater reliability or agreement on clinical scales varied widely. Correspondence with electromyogram results was mixed. There was dissimilarity in patient reports and examiner assessments. Scores from clinical scales are responsive (decrease after initiation of treatment with known effectiveness), but the utility of scores for indexing individual change associated with the natural history of upper motor neuron disease is unknown. Future research incorporating patient reports and examiner findings over time will help to clarify the definition and capture the essence of spasticity.