Spasticity syndrome in cerebral pathology: evaluation and clinical models
Knowing the frequency of spasticity patterns in different muscles allows correcting the botulinum neurotoxin (BoNT) administration schemes and creating spasticity models that could predict the drug consumption and treatment cost.Objective: to develop clinical spasticity models based on the frequenci...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | Russian |
| Published: |
IMA-PRESS LLC
2021-10-01
|
| Series: | Неврология, нейропсихиатрия, психосоматика |
| Subjects: | |
| Online Access: | https://nnp.ima-press.net/nnp/article/view/1668 |
| _version_ | 1827062753856061440 |
|---|---|
| author | A. P. Kovalenko I. A. Voznyuk V. K. Misikov |
| author_facet | A. P. Kovalenko I. A. Voznyuk V. K. Misikov |
| author_sort | A. P. Kovalenko |
| collection | DOAJ |
| description | Knowing the frequency of spasticity patterns in different muscles allows correcting the botulinum neurotoxin (BoNT) administration schemes and creating spasticity models that could predict the drug consumption and treatment cost.Objective: to develop clinical spasticity models based on the frequencies of the spastic syndrome in the muscles of the extremities in post-stroke patients to optimize BoNT administration.Patients and methods. We examined 129 patients of both sexes aged 61.2±8.0 years with post-stroke spasticity (mean time after the stroke – 4.6±2.2). Twenty-seven muscles were tested for spasticity: shoulder girdle (n=3), upper (n=9) and lower (n=15) extremities. We used the original manual testing methods (MTM) of spasticity and the Tardieu scale (TS).Results and discussion. We observed the following frequencies of spasticity in the arm muscles: pectoralis major, brachioradialis, pronator teres, fl. carpi radialis, fl. digitorum profundus et superfacialis, fl. pollicis long. – over 70%, subscapularis – 61%, brachialis – 56.6%, biceps brachii – 35.8%. Frequencies of spasticity in the leg muscles were: semitendinosus, semimembranosus, fl. digitorum long. – 37.5%, gracilis – 21.4%, cap. med. gastrocnemius – 48%, tibialis post. – 39.2%, soleus – 19.6%, fl. halluces long. – 23%. There was no spasticity in the hip adductors; low spasticity incidence was seen in fl. digitorum brev. et fl. halluces brev. (<10%), tibialis ant., rectus femoris (<5%); biceps femoris, teres major, fl. carpi ulnaris, and cap. lat. gastrocnemius (<2%). Based on the frequency of identified spastic patterns, we created four models of patients with arm spasticity and five models – with leg spasticity with the calculation of the necessary doses of BoNT.Conclusion. We propose several spasticity models, which allow calculating the treatment costs, considering the frequency of involvement of specific muscles in spasticity evaluation, and tracking the rehabilitation follow-up of the patient's transition from one clinical model to another. |
| first_indexed | 2024-04-10T02:01:30Z |
| format | Article |
| id | doaj.art-f8c6d75d40654173a1fc05f992656605 |
| institution | Directory Open Access Journal |
| issn | 2074-2711 2310-1342 |
| language | Russian |
| last_indexed | 2025-02-18T20:01:55Z |
| publishDate | 2021-10-01 |
| publisher | IMA-PRESS LLC |
| record_format | Article |
| series | Неврология, нейропсихиатрия, психосоматика |
| spelling | doaj.art-f8c6d75d40654173a1fc05f9926566052024-10-17T16:15:29ZrusIMA-PRESS LLCНеврология, нейропсихиатрия, психосоматика2074-27112310-13422021-10-01135687510.14412/2074-2711-2021-5-68-751190Spasticity syndrome in cerebral pathology: evaluation and clinical modelsA. P. Kovalenko0I. A. Voznyuk1V. K. Misikov2S.M. Kirov Military Medical Academy, Ministry of Defense of RussiaS.M. Kirov Military Medical Academy, Ministry of Defense of Russia; I.I. Janelidze St. Petersburg Research Institute of Emergency MedicineM.F. Vladimirsky Moscow Regional Research Clinical InstituteKnowing the frequency of spasticity patterns in different muscles allows correcting the botulinum neurotoxin (BoNT) administration schemes and creating spasticity models that could predict the drug consumption and treatment cost.Objective: to develop clinical spasticity models based on the frequencies of the spastic syndrome in the muscles of the extremities in post-stroke patients to optimize BoNT administration.Patients and methods. We examined 129 patients of both sexes aged 61.2±8.0 years with post-stroke spasticity (mean time after the stroke – 4.6±2.2). Twenty-seven muscles were tested for spasticity: shoulder girdle (n=3), upper (n=9) and lower (n=15) extremities. We used the original manual testing methods (MTM) of spasticity and the Tardieu scale (TS).Results and discussion. We observed the following frequencies of spasticity in the arm muscles: pectoralis major, brachioradialis, pronator teres, fl. carpi radialis, fl. digitorum profundus et superfacialis, fl. pollicis long. – over 70%, subscapularis – 61%, brachialis – 56.6%, biceps brachii – 35.8%. Frequencies of spasticity in the leg muscles were: semitendinosus, semimembranosus, fl. digitorum long. – 37.5%, gracilis – 21.4%, cap. med. gastrocnemius – 48%, tibialis post. – 39.2%, soleus – 19.6%, fl. halluces long. – 23%. There was no spasticity in the hip adductors; low spasticity incidence was seen in fl. digitorum brev. et fl. halluces brev. (<10%), tibialis ant., rectus femoris (<5%); biceps femoris, teres major, fl. carpi ulnaris, and cap. lat. gastrocnemius (<2%). Based on the frequency of identified spastic patterns, we created four models of patients with arm spasticity and five models – with leg spasticity with the calculation of the necessary doses of BoNT.Conclusion. We propose several spasticity models, which allow calculating the treatment costs, considering the frequency of involvement of specific muscles in spasticity evaluation, and tracking the rehabilitation follow-up of the patient's transition from one clinical model to another.https://nnp.ima-press.net/nnp/article/view/1668spasticity testingspasticity frequencybotulinum neurotoxinspasticitymodels (patterns) of spasticitypost-stroke rehabilitation |
| spellingShingle | A. P. Kovalenko I. A. Voznyuk V. K. Misikov Spasticity syndrome in cerebral pathology: evaluation and clinical models Неврология, нейропсихиатрия, психосоматика spasticity testing spasticity frequency botulinum neurotoxin spasticity models (patterns) of spasticity post-stroke rehabilitation |
| title | Spasticity syndrome in cerebral pathology: evaluation and clinical models |
| title_full | Spasticity syndrome in cerebral pathology: evaluation and clinical models |
| title_fullStr | Spasticity syndrome in cerebral pathology: evaluation and clinical models |
| title_full_unstemmed | Spasticity syndrome in cerebral pathology: evaluation and clinical models |
| title_short | Spasticity syndrome in cerebral pathology: evaluation and clinical models |
| title_sort | spasticity syndrome in cerebral pathology evaluation and clinical models |
| topic | spasticity testing spasticity frequency botulinum neurotoxin spasticity models (patterns) of spasticity post-stroke rehabilitation |
| url | https://nnp.ima-press.net/nnp/article/view/1668 |
| work_keys_str_mv | AT apkovalenko spasticitysyndromeincerebralpathologyevaluationandclinicalmodels AT iavoznyuk spasticitysyndromeincerebralpathologyevaluationandclinicalmodels AT vkmisikov spasticitysyndromeincerebralpathologyevaluationandclinicalmodels |