Svetlana Pundik1, Jessica McCabe2, Margaret Skelly3, Curtis Tatsuoka4, Janis J Daly5. 1. Louis Stokes Cleveland VA Medical Center, 10701, East Boulevard, Cleveland, OH 44106, USA; Department of Neurology, Case Western Reserve University School of Medicine, 11100, Euclid avenue, Cleveland, OH 44106, USA. Electronic address: sxp19@case.edu. 2. Louis Stokes Cleveland VA Medical Center, 10701, East Boulevard, Cleveland, OH 44106, USA. Electronic address: jmccabe@fescenter.org. 3. Louis Stokes Cleveland VA Medical Center, 10701, East Boulevard, Cleveland, OH 44106, USA. Electronic address: peggy.skelly@gmail.com. 4. Department of Biostatistics, Case Western Reserve University, 11000, Euclid Avenue, Cleveland, OH 44106, USA. Electronic address: curtis.tatsuoka@case.edu. 5. Department of Neurology, College of Medicine, University of Florida; McKnight Brain Institute, University of Florida, 1149 Newell Drive, Gainesville, FL 32611, USA; Department of VA National Brain Rehabilitation Research Center of Excellence, Research Service, 151-A, 1611 S.W. Archer Road, Gainesville, FL 32608, USA. Electronic address: Janis.daly@neurology.ufl.edu.
Abstract
BACKGROUND: The prevalence of increased muscle tone after stroke is frequently reported as 30% to 40%, and the condition is often concurrent with motor control deficits, manifesting as an inability to isolate paretic-limb joint movements. OBJECTIVE: The objectives of this retrospective analysis were to 1) report the prevalence of increased muscle tone in a convenience sample of 128 chronic stroke survivors with moderate/severe motor deficits and 2) quantify the relation between tone and motor impairment in chronic stroke survivors. METHODS: Analyses included descriptive statistics and multiple regression modeling, with the modified Ashworth Scale score (MAS; tone) as a predictor of isolated joint movement control (Fugl-Meyer score [FM]; motor impairment). RESULTS: Increased muscle tone was present in 97% of subjects. Increased muscle tone was associated with impaired motor control (FM; upper extremity, P=0.008; lower extremity, P=0.03) after adjusting for age, time since stroke and sex. We found a significant difference between flexor and extensor strength for finger, elbow, hip and knee joints (P<0.002). Participants were classified in high and low MAS score groups. With high MAS score and for muscles of finger flexion and forearm pronation, we found a trend toward impaired strength of antagonist muscles (finger extensors and forearm supinators, respectively) as compared with low MAS score for these same muscle pairings. CONCLUSIONS: The prevalence of increased tone was higher in this study than in previous reports. Increased muscle tone in chronic stroke survivors with persistent motor dysfunction could be associated with impaired motor control and differential muscle strength of antagonistic muscles. Published by Elsevier Masson SAS.
BACKGROUND: The prevalence of increased muscle tone after stroke is frequently reported as 30% to 40%, and the condition is often concurrent with motor control deficits, manifesting as an inability to isolate paretic-limb joint movements. OBJECTIVE: The objectives of this retrospective analysis were to 1) report the prevalence of increased muscle tone in a convenience sample of 128 chronic stroke survivors with moderate/severe motor deficits and 2) quantify the relation between tone and motor impairment in chronic stroke survivors. METHODS: Analyses included descriptive statistics and multiple regression modeling, with the modified Ashworth Scale score (MAS; tone) as a predictor of isolated joint movement control (Fugl-Meyer score [FM]; motor impairment). RESULTS: Increased muscle tone was present in 97% of subjects. Increased muscle tone was associated with impaired motor control (FM; upper extremity, P=0.008; lower extremity, P=0.03) after adjusting for age, time since stroke and sex. We found a significant difference between flexor and extensor strength for finger, elbow, hip and knee joints (P<0.002). Participants were classified in high and low MAS score groups. With high MAS score and for muscles of finger flexion and forearm pronation, we found a trend toward impaired strength of antagonist muscles (finger extensors and forearm supinators, respectively) as compared with low MAS score for these same muscle pairings. CONCLUSIONS: The prevalence of increased tone was higher in this study than in previous reports. Increased muscle tone in chronic stroke survivors with persistent motor dysfunction could be associated with impaired motor control and differential muscle strength of antagonistic muscles. Published by Elsevier Masson SAS.
Authors: Yu Liu; Hong Li; Jun Zhang; Qing-Qing Zhao; Hao-Nan Mei; Jiang Ma Journal: Evid Based Complement Alternat Med Date: 2021-11-28 Impact factor: 2.629