F-1-04-03
Measuring Spasticity of Wrist Flexors in Hemiplegic Patients
Keizo Shigenobu, Jiro Kawamura (Osaka Rosai Hospital, Sakai, Japan)
Takahiro Kanaoka, Kazuyoshi Nishihara (Osaka Electro-Communication University, Ncyagawa, Japan)
Purpose; To report a simple device for measuring spasticity of the wrist flexors in hemiplegic patients.
Method; The device is a modification developed by Alfieri and Knutsson in 1992. The main aspect of modification was the direction of its wheel axis from horizontal to vertical position to eliminate effects of gravity of hand. A string around the wheel rotates the wheel by dropping the weight load which was attached to the end of the string, forcing the wrist joint extension. The angle of rotation was detected by a potentiometer transferred to a personal computer through a A/D converter.
Result; The extent of rotation (EOR) was measured using this system in sixteen hemiplegic patients and 8 normal subjects and the wrist flexor of patients were also evaluated using Ashworth Scale. As the Ashworth Scale became higher, EOR became lower. This correlation was significant with 95% confidence.
Conclusion; Our system is simple but a valid method for measuring spasticity quantitatively for the hemiplegic hand.
REFERENCES: Alfieri V and Knutsson E: The "stretch reflex indicator" an instrument for measurement of spasticity in clinical practice. Proceedings of the VI Mediterranean Conference on Medical and Biological Engineering. Vol. II, Capri, 1992, pp.1309-1312.
F-1-04-04
BOTULINUM TOXIN TYPE A BOTOX FOR THE TREATMENT OF SPASTICITY OF THE LOWER LIMB IN STROKE PATIENT
Sposito, M.M.M.,MD*;Condratcki, S.,Ft.
*Medical Doctor of Escola Paulista de Medicina - Universidade Federal de Sao Paulo - Sao Paulo / SP - Brasil
Between March/95 and December/96, 17 stroke patients (15 males/12 females) with mean-age 48,82±15,76 yeas (min 13 / max 69) were treated with BOTOX for periferical block in lower limb. First of all the patients were evaluated clinically, than we took tapes of them, and finely all were protocolated to obtain one score based on: osteotendineos reflex, clonus, activities of daily livings, Ashworth scale, goniometry, and functional activities. By the functional evaluation we could decide the muscles and doses to be used. The most treated muscles were gastrocnemius - lateral and medial head and rectus femoris. All patients were re-evaluated in 22,53±19,40 days (min 5 / max 75) and were followed for 4,10±3,25 months (min 1 / max 12). When we compared the score and the Ashworth scale data among pre proceeding, first pos and final evaluation and analyzed in parametrical and non parametrical bases, all patients improved significantly.
