Quantitative Measurement of Poststroke Spasticity and Response to Treatment With Botulinum Toxin:

Background and Purpose. Spasticity (hypertonicity) is a frequent problem that can develop after stroke and can lead to a number of secondary complications, such as contractures and pain. Consequently, many rehabilitation resources are used in treating the condition and its secondary complications. At present, the clinical assessment of spasticity incorporates descriptive scales of resistance to passive movement, but the use of a neurophysiological measure of muscle activity levels has been advocated. This case report focuses on the diagnosis of spasticity through the use of a neurophysiological measure. Case Descriptions. Two individuals who required botulinum toxin treatment for poststroke spasticity were assessed over a course of 20 weeks with both clinical (Modified Ashworth Scale) and neurophysiological (surface electromyography re-cording of levels of muscle activity) measures of spasticity. Additionally, arm func-tion, arm movement, and pain were measured. The individuals ’ responses to treat-ment with botulinum toxin and overall recovery after stroke are described. Outcomes. There were discrepancies between the clinical and the neurophysi