Movement kinematics and proprioception in post-stroke spasticity: assessment using the Kinarm robotic exoskeleton

Don't you believe in to do nothingism of Dr. William M. Landau on spasticity?  

His statement from here:

Spasticity After Stroke: Why Bother? Aug. 2004

However, the perseverative preoccupation of professional neurologists and therapists with the purpose of overpowering the spasticity ogre seems to be an endemic, intractably-taught delusion that afflicts both academic scholars and clinicians.

I really do hope that schadenfreude hits him directly, he can then see that spasticity needs to be solved and is not a delusion.  But that will be too late for the

30% of survivors that have it. (3 million survivors each year that can directly blame him for lack of progress on spasticity.)  I suppose I shouldn't call out persons by name but his is an especially egregious example of  wrong headed thinking. I'm using egregious in the current definition, not from the Latin word egregius, meaning "distinguished" or "eminent."

Movement kinematics and proprioception in post-stroke spasticity: assessment using the Kinarm robotic exoskeleton

• George Mochizuki,
• Andrew Centen,
• Myles Resnick,
• Catherine Lowrey,
• Sean P. Dukelow &
• Stephen H. Scott 

Journal of NeuroEngineering and Rehabilitation volume 16, Article number: 146 (2019) Cite this article

Abstract

Background

Motor impairment after stroke interferes with performance of everyday activities. Upper limb spasticity may further disrupt the movement patterns that enable optimal function; however, the specific features of these altered movement patterns, which differentiate individuals with and without spasticity, have not been fully identified. This study aimed to characterize the kinematic and proprioceptive deficits of individuals with upper limb spasticity after stroke using the Kinarm robotic exoskeleton.

Methods

Upper limb function was characterized using two tasks: Visually Guided Reaching, in which participants moved the limb from a central target to 1 of 4 or 1 of 8 outer targets when cued (measuring reaching function) and Arm Position Matching, in which participants moved the less-affected arm to mirror match the position of the affected arm (measuring proprioception), which was passively moved to 1 of 4 or 1 of 9 different positions. Comparisons were made between individuals with (n = 35) and without (n = 35) upper limb post-stroke spasticity.

Results

Statistically significant differences in affected limb performance between groups were observed in reaching-specific measures characterizing movement time and movement speed, as well as an overall metric for the Visually Guided Reaching task. While both groups demonstrated deficits in proprioception compared to normative values, no differences were observed between groups. Modified Ashworth Scale score was significantly correlated with these same measures.

Conclusions

The findings indicate that individuals with spasticity experience greater deficits in temporal features of movement while reaching, but not in proprioception in comparison to individuals with post-stroke motor impairment without spasticity. Temporal features of movement can be potential targets for rehabilitation in individuals with upper limb spasticity after stroke.