Measurement of ankle spasticity in children with cerebral palsy using a manual spasticity evaluator

Spastic hypertonia involving spasticity and/or contracture is a major source of disability in cerebral palsy and other neurological impairments like stroke. Several measures have been used to assess the reflex hyperexcitability and hypertonus associated with spasticity, including the Ashworth scale, tendon reflex scale, pendulum test, mechanical perturbations and passive joint ROM. These measures generally are either convenient to use in clinics but not quantitative or they are quantitative but difficult to use conveniently in clinics. We developed a manual spasticity evaluator (MSE) to evaluate the spasticity/contracture quantitatively and conveniently in a clinical setting. Using the MSE, we measured the ankle ROM at controlled low velocity, elastic stiffness, and Tardieu R₁ catch angle at different velocities. The results show decreased ROM and increased stiffness in spastic ankle, and the Tardieu R1 catch angle was approximately linearly related to the movement velocity.