JORR

The Journal of Orthopedics Research and Rehabilitation welcomes scholarly papers inorthopaedic surgery, physical therapy and rehabilitation, neurosurgery, neurology and clinic anesthesiology and reanimation.

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Original Article
Comparison of spasticity measurements with surface electromyography in the affected and unaffected side of children with hemiparetic cerebral palsy
Aims: Various methods are used in the evaluation of spasticity, which is common in Cerebral Palsy (CP). However, studies measuring upper extremity spasticity with Surface Electromyography (sEMG) were found to be insufficient in children with CP. In this study, the comparison of Modified Ashworth Scale (MAS) and sEMG measurements for bilateral upper extremity spasticity in children with Hemiparetic CP was aimed.
Methods: 33 (11.03 ± 3.82 years, 11F-2M) patients with hemiparetic CP and 32 healthy controls (10.31± 2.88 years, 16F-16M) with a similar mean age were included in the study.
Results: Upper extremity spasticities of both sides of the cases were evaluated with MAS and SEMG. Affected side MAS results were found to be higher than the unaffected side (p<0.05). The mean sEMG value of the wrist flexors was lower on the affected side during voluntary contraction and higher during voluntary relaxation (p<0.05). In addition, the maximum percentage of voluntary contraction was measured higher on the affected side (p<0.05).
Conclusion: Spasticity, as assessed by sEMG and MAS, was increased on the affected side. MAS and sEMG give consistent results. These results show us that the YEMG method can be used for spasticity measurements. It is considered that MAS would be a preferable method in evaluating spasticity owing to the fact that it is easy to use and it does not constitute extra costs.


1. Cans C. Surveillance of cerebral palsy in Europe: a collaboration ofcerebral palsy surveys and registers. Surveillance of Cerebral Palsyin Europe (SCPE).Dev Med Child Neurol. 2000;42(12):816-824.doi:10.1017/s0012162200001511
2. Beckung E, Hagberg G. Neuroimpairments, activity limitations, andparticipation restrictions in children with cerebral palsy.Dev MedChild Neurol. 2002;44(5):309-316. doi:10.1017/s0012162201002134
3. Sanger TD. Movement Disorders in Cerebral Palsy. J Pediatr Neurol.2015; 13(04):198-207.
4. Pascual JM, Koenigsberger MR. Par&aacute;lisis cerebral: factores deriesgo prenatales [Cerebral palsy: prenatal risk factors].Rev Neurol.2003;37(3):275-280.
5. Erol E, Elbasan B, Erol B&Ouml;, et al. Pediatrik fizyoterapi rehabilitasyon&uuml;nitesine başvuran hastaların demografik &ouml;zellikleri. Gazi SağlıkBilim Derg. 2016; 1(1): 49-59.
6. Kutlay S. Spastik El, T&uuml;rkiye Klinikleri. J PM&amp;R Special Topics. 2008;1:84-97.
7. Rosales RL, Chua-Yap AS. Evidence-based systematic review onthe efficacy and safety of botulinum toxin-A therapy in post-strokespasticity.J Neural Transm (Vienna). 2008;115(4):617-623. doi:10.1007/s00702-007-0869-3
8. McCall JV, Ludovice MC, Blaylock JA, Kamper DG. A Platform forRehabilitation of Finger Individuation in Children with HemiplegicCerebral Palsy.IEEE Int Conf Rehabil Robot. 2019;2019:343-348.doi:10.1109/ICORR.2019.8779537
9. Shaw L, Rodgers H, Price C, et al. BoTULS: a multicentre randomisedcontrolled trial to evaluate the clinical effectiveness and cost-effectiveness of treating upper limb spasticity due to stroke withbotulinum toxin type A.Health Technol Assess. 2010;14(26):1-iv.doi:10.3310/hta14260
10. Unlu E, &Ccedil;evikol A, &Ccedil;akcı A. Spastik Elde Değerlendirme ve TedaviYontemleri. FTR Bil Der. 2011; 24(7):24-27.
11. Keklicek H, Uygur F, Yakut Y. Effects of taping the hand in childrenwith cerebral palsy.J Hand Ther. 2015;28(1):27-33. doi:10.1016/j.jht.2014.09.007
12. Surkar SM, Hoffman RM, Willett S, Flegle J, Harbourne R, Kurz MJ.Hand-arm bimanual intensive therapy improves prefrontal cortexactivation in children with hemiplegic cerebral palsy.Pediatr PhysTher. 2018;30(2):93-100. doi:10.1097/PEP.0000000000000486
13. Rasool G, Afsharipour B, Suresh NL, Rymer WZ. Spatial Analysisof Multichannel Surface EMG in Hemiplegic Stroke.IEEE TransNeural Syst Rehabil Eng. 2017;25(10):1802-1811. doi:10.1109/TNSRE.2017.2682298
14. Li Y, Zhang X, Gong Y, Cheng Y, Gao X, Chen X. Motor functionevaluation of hemiplegic upper-extremities using data fusionfrom wearable inertial and surface EMG sensors.Sensors (Basel).2017;17(3):582. doi:10.3390/s17030582
15. Alhusaini AA, Dean CM, Crosbie J, Shepherd RB, Lewis J. Evaluationof spasticity in children with cerebral palsy using Ashworth andTardieu Scales compared with laboratory measures.J Child Neurol.2010;25(10):1242-1247. doi:10.1177/0883073810362266
16. Alibiglou L, Rymer WZ, Harvey RL, Mirbagheri MM. The relationbetween Ashworth scores and neuromechanical measurementsof spasticity following stroke.J Neuroeng Rehabil. 2008;5:18.doi:10.1186/1743-0003-5-18
17. Başarır M, &Ouml;zek MM. Spastisite ve tedavisi. T&uuml;rk N&ouml;roşir Derg. 2013;23:158-173.
18. Cerrah AO, Ertan H, Soylu AR. Spor bilimlerinde elektromiyografikullanımı. Spormetre Beden Eğitimi ve Spor Bilimleri Derg. 2010; 8(2):43-49.
19. Lei Wang, Xin Guo, Peng Fang, et al. A new EMG-based index towardsthe assessment of elbow spasticity for post-stroke patients.AnnuInt Conf IEEE Eng Med Biol Soc. 2017;2017:3640-3643. doi:10.1109/EMBC.2017.8037646
20. Hayran M, Hayran M. Sağlık araştırmaları i&ccedil;in temel istatistik, 1.baskı, Omega araştırma, Ankara, 2011.
21. Kaya Kara &Ouml;, T&uuml;rker D, &Ouml;zal C, et al. Serebral Palsi&rsquo;de g&uuml;ncelfizyoterapi ve rehabilitasyon yaklaşımları. Ufkun &Ouml;tesi Bilim Derg.2010; 10(1-2): 5-22
22. Nielsen JB, Crone C, Hultborn H. The spinal pathophysiology ofspasticity--from a basic science point of view.Acta Physiol (Oxf).2007;189(2):171-180. doi:10.1111/j.1748-1716.2006.01652.x
23. Numanoğlu A, G&uuml;nel MK. Intraobserver reliability of modifiedAshworth scale and modified Tardieu scale in the assessment ofspasticity in children with cerebral palsy.Acta Orthop Traumatol Turc.2012;46(3):196-200. doi:10.3944/aott.2012.2697
24. Biering-S&oslash;rensen F, Nielsen JB, Klinge K. Spasticity-assessment: areview.Spinal Cord. 2006;44(12):708-722. doi:10.1038/sj.sc.3101928
25. Pandyan AD, Price CI, Barnes MP, Johnson GR. A biomechanicalinvestigation into the validity of the modified Ashworth Scale asa measure of elbow spasticity.Clin Rehabil. 2003;17(3):290-293.doi:10.1191/0269215503cr610oa
26. Ansari NN, Naghdi S, Hasson S, Azarsa MH, Azarnia S. The ModifiedTardieu Scale for the measurement of elbow flexor spasticity inadult patients with hemiplegia.Brain Inj. 2008;22(13-14):1007-1012.doi:10.1080/02699050802530557
27. Yam WK, Leung MS. Interrater reliability of Modified Ashworth Scaleand Modified Tardieu Scale in children with spastic cerebral palsy.JChild Neurol. 2006;21(12):1031-1035. doi:10.1177/7010.2006.00222
28. Malhotra S, Pandyan AD, Day CR, Jones PW, Hermens H. Spasticity,an impairment that is poorly defined and poorly measured.ClinRehabil. 2009;23(7):651-658. doi:10.1177/0269215508101747
29. Fleuren JF, Voerman GE, Erren-Wolters CV, et al. Stop using theAshworth Scale for the assessment of spasticity.J Neurol NeurosurgPsychiatry. 2010;81(1):46-52. doi:10.1136/jnnp.2009.177071
30. Tederko P, Krasuski M, Czech J, Dargiel A, Garwacka-Jodzis I,Wojciechowska A. Reliability of clinical spasticity measurements inpatients with cervical spinal cord injury.Ortop Traumatol Rehabil.2007;9(5):467-483.
31. Craven BC, Morris AR. Modified Ashworth scale reliability formeasurement of lower extremity spasticity among patients withSCI.Spinal Cord. 2010;48(3):207-213. doi:10.1038/sc.2009.107
32. Alibiglou L, Rymer WZ, Harvey RL, Mirbagheri MM. The relationbetween Ashworth scores and neuromechanical measurementsof spasticity following stroke. J Neuroeng Rehabil. 2008;5:18.doi:10.1186/1743-0003-5-18.
33. Wakeling J, Delaney R, Dudkiewicz I. A method for quantifyingdynamic muscle dysfunction in children and young adults withcerebral palsy.Gait Posture. 2007;25(4):580-589. doi:10.1016/j.gaitpost.2006.06.009
34. Lieber RL, Steinman S, Barash IA, Chambers H. Structural andfunctional changes in spastic skeletal muscle.Muscle Nerve.2004;29(5):615-627. doi:10.1002/mus.20059
35. Kupa EJ, Roy SH, Kandarian SC, De Luca CJ. Effects of muscle fibertype and size on EMG median frequency and conduction velocity.JAppl Physiol (1985). 1995;79(1):23-32. doi:10.1152/jappl.1995.79.1.23
36. Wakeling JM, Rozitis AI. Spectral properties of myoelectric signalsfrom different motor units in the leg extensor muscles.J Exp Biol.2004;207(Pt 14):2519-2528. doi:10.1242/jeb.01042
37. Garciaa MAC, Vieiria TMM. Surface electromyography: Why, whenand how to use it. Rev Andal Med Deporte. 2011; 4(1):17-28.
38. Cerrah AO, Ertan H, Soylu AR. Elektromiyografi ile kuvvetindeğerlendirilmesi. T&uuml;rkiye Klinikleri J Neur. 2010; 5(3):160-166.
39. Yarosh CA, Hoffman DS, Strick PL. Deficits in movements of thewrist ipsilateral to a stroke in hemiparetic subjects.J Neurophysiol.2004;92(6):3276-3285. doi:10.1152/jn.00549.2004
40. Wiley ME, Damiano DL. Lower-extremity strength profiles inspastic cerebral palsy.Dev Med Child Neurol. 1998;40(2):100-107.doi:10.1111/j.1469-8749.1998.tb15369.x
41. Staudt M, Grodd W, Gerloff C, Erb M, Stitz J, Kr&auml;geloh-Mann I. Twotypes of ipsilateral reorganization in congenital hemiparesis: a TMSand fMRI study. Brain. 2002;125(Pt 10):2222-2237. doi:10.1093/brain/awf227
Volume 1, Issue 2, 2023
Page : 26-31
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