Relationship Between Spasticity and Upper-Limb Movement Disorders in Individuals With Subacute Stroke Using Stochastic Spatiotemporal Modeling

So we still know nothing factual about spasticity and movement. Until we get factual information we will never be able to fix the spasticity problem.  Spasticity has NO cure, so the 30% of survivors that get this will never recover. Botox and muscle relaxants don't cure spasticity, in fact they make it less likely that the cure to spasticity will ever be found. I blame that lack of spasticity cure directly at Dr. William M. Landaus' feet because of this totally misguided crapola of his.

Spasticity After Stroke: Why Bother?Aug. 2004 

Good stroke leadership from survivors and a strategy could have gotten around his blockade. Schadenfreude would be too good for him.  

The latest here:

Relationship Between Spasticity and Upper-Limb Movement Disorders in Individuals With Subacute Stroke Using Stochastic Spatiotemporal Modeling 

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Isgav Davidowitz, MSc, Yisrael Parmet, MSc, PhD, Silvi Frenkel-Toledo, MSc, PhD, ...

First Published February 11, 2019 Research Article

https://doi.org/10.1177/1545968319826050

Article information

Abstract

Background. Spasticity is common in patients with stroke, yet current quantification methods are insufficient for determining the relationship between spasticity and voluntary movement deficits. This is partly a result of the effects of spasticity on spatiotemporal characteristics of movement and the variability of voluntary movement. These can be captured by Gaussian mixture models (GMMs). Objectives. To determine the influence of spasticity on upper-limb voluntary motion, as assessed by the bidirectional Kullback-Liebler divergence (BKLD) between motion GMMs.  
Methods. A total of 16 individuals with subacute stroke and 13 healthy aged-equivalent controls reached to grasp 4 targets (near-center, contralateral, far-center, and ipsilateral). Two-dimensional GMMs (angle and time) were estimated for elbow extension motion. BKLD was computed for each individual and target, within the control group and between the control and stroke groups. Movement time, final elbow angle, average elbow velocity, and velocity smoothness were computed.  
Results. Between-group BKLDs were much larger than within control-group BKLDs. Between-group BKLDs for the near-center target were lower than those for the far-center and contralateral targets, but similar to that for the ipsilateral target. For those with stroke, the final angle was lower for the near-center target, and the average velocity was higher. Velocity smoothness was lower for the near-center than for the ipsilateral target. Elbow flexor and extensor passive muscle resistance (Modified Ashworth Scale) strongly explained BKLD values.  
Conclusions. Results support the view that individuals with poststroke spasticity have a velocity-dependent reduction in active elbow joint range and that BKLD can be used as an objective measure of the effects of spasticity on reaching kinematics.