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Reliability and validity of pendulum test measures of spasticity obtained with the Polhemus tracking system from patients with chronic stroke.

Bohannon RW, Harrison S, Kinsella-Shaw J - J Neuroeng Rehabil (2009)

Bottom Line: Three measures obtained from pendular traces of the affected side were reliable (intraclass correlation coefficient > or = .844).Known groups validity was confirmed by demonstration of a significant difference in the measurements between sides.Convergent validity was supported by correlations > or = .57 between pendulum test measures and other measures reflective of spasticity.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Physical Therapy, Neag School of Education, University of Connecticut, Storrs, USA. richard.bohannon@uconn.edu

ABSTRACT

Background: Spasticity is a common impairment accompanying stroke. Spasticity of the quadriceps femoris muscle can be quantified using the pendulum test. The measurement properties of pendular kinematics captured using a magnetic tracking system has not been studied among patients who have experienced a stroke. Therefore, this study describes the test-retest reliability and known groups and convergent validity of the pendulum test measures obtained with the Polhemus tracking system.

Methods: Eight patients with chronic stroke underwent pendulum tests with their affected and unaffected lower limbs, with and without the addition of a 2.2 kg cuff weight at the ankle, using the Polhemus magnetic tracking system. Also measured bilaterally were knee resting angles, Ashworth scores (grades 0-4) of quadriceps femoris muscles, patellar tendon (knee jerk) reflexes (grades 0-4), and isometric knee extension force.

Results: Three measures obtained from pendular traces of the affected side were reliable (intraclass correlation coefficient > or = .844). Known groups validity was confirmed by demonstration of a significant difference in the measurements between sides. Convergent validity was supported by correlations > or = .57 between pendulum test measures and other measures reflective of spasticity.

Conclusion: Pendulum test measures obtained with the Polhemus tracking system from the affected side of patients with stroke have good test-retest reliability and both known groups and convergent validity.

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Related in: MedlinePlus

Pendulum test traces from all subjects. Those on the left are from the unaffected side while those on the right are from the affected side. Blue dashed lines represent traces obtained without weights whereas red solid lines represent traces obtained with weights.
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Figure 3: Pendulum test traces from all subjects. Those on the left are from the unaffected side while those on the right are from the affected side. Blue dashed lines represent traces obtained without weights whereas red solid lines represent traces obtained with weights.

Mentions: Pendulum test traces for all subjects are presented in Figure 3. Table 2 summarizes the ICCs associated with the various pendulum test measures obtained from the traces. With the exception of the ICC associated with the velocity to first reversal during testing with no weight on the unaffected side (ICC = .212), all ICCs (.651 to .844) were significant (p < .05). Table 3 compares the pendulum test measures between the affected and unaffected sides. Supporting the known groups validity of the measures, all differed significantly between sides whether or not the test was supplemented with a weight. Convergent validity of the pendulum test measures was affirmed by their strong correlations (.81 to .99) with one another (Table 4). Their validity is further supported by their good correlations with most other motor measures (Table 4). On the involved side, lesser angles of first reversal, smaller areas under the curve, and slower velocities to first reversal were all associated with smaller resting angles (rs = .57 to .71), higher Ashworth scores (rs = -.63 to -.89), greater knee jerks (rs = -.64 to -.79), and lower knee extension forces (rs = .59 to .76). However, only the angles of first reversal were significantly correlated (rs = .71 to -.80, p ≤ ,01) with all of these measures. None of the pendulum test measures correlated significantly (rs = .27 to .57) with gait speed.


Reliability and validity of pendulum test measures of spasticity obtained with the Polhemus tracking system from patients with chronic stroke.

Bohannon RW, Harrison S, Kinsella-Shaw J - J Neuroeng Rehabil (2009)

Pendulum test traces from all subjects. Those on the left are from the unaffected side while those on the right are from the affected side. Blue dashed lines represent traces obtained without weights whereas red solid lines represent traces obtained with weights.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2724410&req=5

Figure 3: Pendulum test traces from all subjects. Those on the left are from the unaffected side while those on the right are from the affected side. Blue dashed lines represent traces obtained without weights whereas red solid lines represent traces obtained with weights.
Mentions: Pendulum test traces for all subjects are presented in Figure 3. Table 2 summarizes the ICCs associated with the various pendulum test measures obtained from the traces. With the exception of the ICC associated with the velocity to first reversal during testing with no weight on the unaffected side (ICC = .212), all ICCs (.651 to .844) were significant (p < .05). Table 3 compares the pendulum test measures between the affected and unaffected sides. Supporting the known groups validity of the measures, all differed significantly between sides whether or not the test was supplemented with a weight. Convergent validity of the pendulum test measures was affirmed by their strong correlations (.81 to .99) with one another (Table 4). Their validity is further supported by their good correlations with most other motor measures (Table 4). On the involved side, lesser angles of first reversal, smaller areas under the curve, and slower velocities to first reversal were all associated with smaller resting angles (rs = .57 to .71), higher Ashworth scores (rs = -.63 to -.89), greater knee jerks (rs = -.64 to -.79), and lower knee extension forces (rs = .59 to .76). However, only the angles of first reversal were significantly correlated (rs = .71 to -.80, p ≤ ,01) with all of these measures. None of the pendulum test measures correlated significantly (rs = .27 to .57) with gait speed.

Bottom Line: Three measures obtained from pendular traces of the affected side were reliable (intraclass correlation coefficient > or = .844).Known groups validity was confirmed by demonstration of a significant difference in the measurements between sides.Convergent validity was supported by correlations > or = .57 between pendulum test measures and other measures reflective of spasticity.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Physical Therapy, Neag School of Education, University of Connecticut, Storrs, USA. richard.bohannon@uconn.edu

ABSTRACT

Background: Spasticity is a common impairment accompanying stroke. Spasticity of the quadriceps femoris muscle can be quantified using the pendulum test. The measurement properties of pendular kinematics captured using a magnetic tracking system has not been studied among patients who have experienced a stroke. Therefore, this study describes the test-retest reliability and known groups and convergent validity of the pendulum test measures obtained with the Polhemus tracking system.

Methods: Eight patients with chronic stroke underwent pendulum tests with their affected and unaffected lower limbs, with and without the addition of a 2.2 kg cuff weight at the ankle, using the Polhemus magnetic tracking system. Also measured bilaterally were knee resting angles, Ashworth scores (grades 0-4) of quadriceps femoris muscles, patellar tendon (knee jerk) reflexes (grades 0-4), and isometric knee extension force.

Results: Three measures obtained from pendular traces of the affected side were reliable (intraclass correlation coefficient > or = .844). Known groups validity was confirmed by demonstration of a significant difference in the measurements between sides. Convergent validity was supported by correlations > or = .57 between pendulum test measures and other measures reflective of spasticity.

Conclusion: Pendulum test measures obtained with the Polhemus tracking system from the affected side of patients with stroke have good test-retest reliability and both known groups and convergent validity.

Show MeSH
Related in: MedlinePlus