Biceps femoris late latency responses and the “notching sign” in spasticity

No clue how this might help your recovery. So go ask your doctor or stroke association as to exactly what will CURE  spasticity.
http://www.jneuroengrehab.com/content/12/1/93

Mehmet Gürbüz¹, Süleyman Bilgin², Yalçın Albayrak²³, Ferah Kızılay¹ and Hilmi Uysal^1*

• * Corresponding author: Hilmi Uysal uysalh@akdeniz.edu.tr

Author Affiliations

¹ Department of Neurology and Neurophysiology, Akdeniz University Faculty of Medicine, B Block Level 2, Dumlupınar Bulvarı, Antalya, 07070, Turkey
² Akdeniz University Faculty of Electric and Electronic Engineering, Antalya, 07070, Turkey
³ Sakarya University Institute of Natural Sciences, Adapazarı, 54000, Turkey

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Journal of NeuroEngineering and Rehabilitation 2015, 12:93  doi:10.1186/s12984-015-0084-7
The electronic version of this article is the complete one and can be found online at: http://www.jneuroengrehab.com/content/12/1/93

Received:	19 June 2015
Accepted:	13 October 2015
Published:	20 October 2015

© 2015 Gürbüz et al.

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

Abstract

Background

Spasticity is a motor impairment due to lesions in the brain and spinal cord. Despite being a well-known problem, difficulties remain in the assessment of the condition. The electrophysiological and kinesiological characteristics of the patellar pendulum changes during the movement triggered by the patellar T reflex could be used to assess spasticity.

Methods

Features of the patellar pendulum during the patellar T reflex were considered using a goniometric approach in spastic patients evaluated with the Ashworth scale. Medium and late latency responses in the rectus and biceps femoris muscles were examined electrophysiologically. For each pendulum, the maximum angle extension during an oscillation of the knee joint, maximal extension time, angular velocities of extensions of the knee joint and frequency of motion due to the patellar reflex were calculated. The damping of the amplitude in the pendulum was calculated.

Results

The spasticity group consisted of 65 patients (38 males and 27 females) with a mean age of 47.6 ± 14.0 years. The normal control group consisted of 25 individuals (19 males and six females) with a mean age of 32.1 ± 10 years. The biceps and rectus femoris long latency late responses were not observed in the normal cases. The biceps femoris medium latency response was observed only in 24 % of healthy individuals; conversely, late responses were observed in 84 % of patients. Activation of the antagonist muscles at a certain level of spasticity created a notching phenomenon. Amplitude of the reflex response and mean angular velocity of the first oscillation present in a dichotomic nature in the spasticity groups. Frequency of the first pendular oscillation increased with the increase of the Ashworth scale, while the damping ratio decreased with increasing scale. The Ashworth scale showed a correlation with the damping ratio. The damping ratio strongly distinguished the spastic subgroups and showed a strong negative correlation with the Ashworth scale.

Conclusions

The Ashworth scale presents a good correlation with kinesiological parameters, but it is only possible to differentiate normal and spastic cases with electrophysiologic parameters. Furthermore, the notching phenomenon could be evaluated as a determinant of spasticity.