Unveiling the Correlations between Clinical Assessment of Spasticity and Muscle Strength and Neurophysiological Testing of Muscle Activity in Incomplete Spinal Cord Injury Patients: The Importance of a Comprehensive Evaluation
Abstract
:Featured Application
Abstract
1. Introduction
2. Materials and Methods
2.1. Patients and Healthy Subjects
2.2. Clinical Assessment Tools
2.2.1. Lovett Scale
2.2.2. Modified Ashworth Scale (MAS)
2.3. sEMG and ENG Recordings
2.4. Statistical Analysis
3. Results
4. Discussion
5. Summary of Recommendation
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Subjects | Age (Years) | Height (cm) | Weight (kg) | Averaged Time from Injury (Months) | ASIA AIS Score | Injury Level |
---|---|---|---|---|---|---|
Patients N = 85 ♀ = 19, ♂ = 66 | 18–64 39.3 ± 9.5 | 153–194 175.7 ± 7.9 | 49–96 61.4 ± 5.3 | 1–2 1.3 ± 0.3 | C = 24 D = 61 | C3–C5 = 16 C6–Th1 = 19 Th3–Th6 = 18 Th7–L1 = 32 |
Control N = 80 ♀ = 17, ♂ = 63 | 18–60 38.1 ± 8.4 | 155–189 173.6 ± 6.3 | 45–91 60.9 ± 4.2 | NA | NA | NA |
p | 0.08 | 0.09 | 0.08 | NA | NA | NA |
Subjects | Injury Level | VAS Score (0–10) | ENG Score (0–3) |
---|---|---|---|
Patients N = 85 ♀ = 19, ♂ = 66 | C3–C5 = 16 C6–Th1 = 19 Th3–Th6 = 18 Th7–L1 = 32 | 0–5 3.0 ± 1.6 0–3 1.9 ± 0.9 0–3 1.3 ± 0.9 0–2 0.9 ± 0.7 | 1–3 2.1 ± 0.9 0–3 1.5 ± 0.9 0–3 1.7 ± 1.0 0–3 1.3 ± 0.8 |
Control N = 80 ♀ = 17, ♂ = 63 | NA | 0–0 0 | 3–3 3.0 |
p | NA | 0.04–0.01 | 0.04–0.03 |
All iSCI Patients (N = 85) | |||||
---|---|---|---|---|---|
Examined Muscle | MAS (0-4) | rsEMG Amplitude (µV) | Lovett (0–5) | mcsEMG Amplitude (µV) | FI (3–0) |
APB | 1–4 1.3 ± 0.7 | 5–150 26.5 ± 7.9 | 1–5 4.3 ± 1.3 | 50–5000 1907.2 ± 122.1 | 1–3 2.3 ± 0.8 |
RECT ABD | 1–3 1.3 ± 0.5 | 5–150 24.9 ± 12.2 | 1–5 2.8 ± 1.4 | 0–2000 466.2 ± 102.3 | 0–3 1.6 ± 0.6 |
RECT FEM | 1–4 1.5 ± 0.6 | 15–25 31.3 ± 14.9 | 0–5 1.9 ± 1.1 | 0–4000 322.4 ± 151.4 | 0–3 1.4 ± 0.6 |
EDB | 1–3 1.4 ± 0.5 | 10–25 29.2 ± 14.1 | 0–5 1.4 ± 0.9 | 0–3000 277.4 ± 137.8 | 0–3 1.0 ± 0.7 |
Total average | 1.4 ± 0.6 | 27.9 ± 12.3 | 2.6 ± 1.1 | 743.3 ± 128.4 | 1.5 ± 0.7 |
Healthy volunteers—Control (N = 80) | |||||
Examined muscle | MAS (0–4) | rsEMG Amplitude (µV) | Lovett (0–5) | mcsEMG Amplitude (µV) | FI (3–0) |
APB | 0–1 0.1 ± 0.3 | 10–25 16.5 ± 1.7 | 5–5 5.0 | 900–6000 2725.3 ± 112.2 | 3–3 3.0 |
RECT ABD | 0–1 0.4 ± 0.2 | 15–25 17.1 ± 2.0 | 4–5 4.9 ± 0.5 | 400–2100 1098.2 ± 212.1 | 2–3 2.8 ± 0.4 |
RECT FEM | 0–0 0 | 15–25 17.4 ± 1.3 | 4–5 4.9 ± 0.6 | 800–4200 1725.1 ± 189.2 | 2–3 2.9 ± 0.3 |
EDB | 0–0 0 | 10–25 16.3 ± 1.8 | 5–5 5.0 | 900–3500 1456.9 ± 191.4 | 3–3 3.0 |
Total average | 0.1 ± 0.2 | 16.8 ± 1.7 | 4.9 ± 0.5 | 1751.3 ± 176.2 | 2.9 ± 0.3 |
p All iSCI patients vs. Control | 0.01 | 0.009 | 0.02 | 0.008 | 0.03 |
Examined Muscle | Test |
Healthy Volunteers (Control) |
Patients C3–C5 |
Patients C6–Th1 |
Patients Th3–Th6 |
Patients Th7–L1 | p Control vs. Patients C3–C5 | p Control vs. Patients C6–Th1 | p Control vs. Patients Th3–Th6 | p Control vs. PatientsTh7–L1 |
---|---|---|---|---|---|---|---|---|---|---|
APB | MAS (0–4) | 0–1 0.1 ± 0.3 | 1–4 2.5 ± 1.3 | 1–4 1.5 ± 0.8 | 1–4 1.5 ± 0.8 | 1–3 1.0 ± 0.2 | 0.01 | 0.03 | 0.03 | 0.04 |
rsEMG Amplitude (µV) | 10–25 16.5 ± 1.7 | 15–150 61.4 ± 14.8 | 10–150 36.2 ± 11.8 | 10–100 17.3 ± 5.4 | 5–100 18.1 ± 8.2 | 0.009 | 0.01 | 0.06 | 0.05 | |
Lovett (0–5) | 5–5 5.0 | 1–5 2.4 ± 1.4 | 1–5 3.2 ± 1.7 | 2–5 4.1 ± 0.7 | 4–5 4.8 ± 0.1 | 0.01 | 0.03 | 0.05 | 0.07 | |
mcsEMG Amplitude (µV) | 900–6000 2725.3 ± 112.2 | 50–1000 375.0 ± 154.1 | 50–2500 831.1 ± 120.3 | 200–4000 2320.2 ± 287.1 | 800–5000 2120.1 ± 192.7 | 0.008 | 0.009 | 0.04 | 0.04 | |
FI (3–0) | 3–3 3.0 | 1–3 1.6 ± 0.8 | 1–3 1.7 ± 0.8 | 1–3 2.6 ± 0.7 | 1–3 2.6 ± 0.6 | 0.01 | 0.01 | 0.05 | 0.05 | |
RECT ABD | MAS (0–4) | 0–1 0.4 ± 0.2 | 1–3 1.6 ± 0.6 | 1–3 1.4 ± 0.5 | 1–3 1.4 ± 0.5 | 1–3 1.1 ± 0.3 | 0.02 | 0.03 | 0.03 | 0.04 |
rsEMG Amplitude (µV) | 15–25 17.1 ± 2.0 | 20–35 27.4 ± 6.4 | 15–100 29.4 ± 9.8 | 10–100 25.3 ± 9.4 | 10–60 20.5 ± 9.6 | 0.02 | 0.01 | 0.04 | 0.05 | |
Lovett (0–5) | 4–5 4.9 ± 0.5 | 1–4 2.1 ± 1.1 | 1–4 1.9 ± 1.1 | 1–5 2.8 ± 1.3 | 1–5 3.6 ± 1.4 | 0.02 | 0.02 | 0.03 | 0.04 | |
mcsEMG Amplitude (µV) | 400–2100 1098.2 ± 212.1 | 50–500 216.6 ± 65.3 | 0–600 242.5 ± 68.1 | 100–1200 422.7 ± 150.1 | 100–2000 672.0 ± 76.6 | 0.008 | 0.009 | 0.01 | 0.03 | |
FI (3–0) | 2–3 2.8 ± 0.4 | 1–2 1.6 ± 0.5 | 0–3 1.5 ± 0.6 | 1–3 2.1 ± 0.5 | 1–3 2.1 ± 0.7 | 0.01 | 0.01 | 0.03 | 0.03 | |
RECT FEM | MAS (0–4) | 0–0 0 | 1–3 1.8 ± 0.5 | 1–4 1.7 ± 0.6 | 1–4 1.7 ± 0.7 | 1–3 1.3 ± 0.5 | 0.02 | 0.02 | 0.02 | 0.03 |
rsEMG Amplitude (µV) | 15–25 17.4 ± 1.3 | 20–45 33.4 ± 12.1 | 10–100 34.2 ± 14.1 | 15–100 31.3 ± 8.9 | 10–60 26.8 ± 10.3 | 0.02 | 0.02 | 0.02 | 0.03 | |
Lovett (0–5) | 4–5 4.9 ± 0.6 | 1–4 2.1 ± 1.3 | 0–5 1.9 ± 1.6 | 0–5 1.8 ± 1.3 | 0–5 1.8 ± 1.4 | 0.01 | 0.01 | 0.01 | 0.01 | |
mcsEMG Amplitude (µV) | 800–4200 1725.1 ± 189.2 | 50–500 219.2 ± 73.8 | 0–1500 290.2 ± 80.1 | 0–1500 282.1 ± 141.5 | 0–4000 390.1 ± 68.2 | 0.009 | 0.01 | 0.01 | 0.02 | |
FI (3–0) | 2–3 2.9 ± 0.3 | 1–2 1.5 ± 0.5 | 0–3 1.2 ± 0.6 | 0–3 1.5 ± 0.6 | 0–3 1.4 ± 0.6 | 0.009 | 0.008 | 0.009 | 0.009 | |
EDB | MAS (0–4) | 0–0 0 | 1–3 1.6 ± 0.7 | 1–3 1.3 ± 0.4 | 1–3 1.3 ± 0.4 | 1–3 1.4 ± 0.6 | 0.02 | 0.03 | 0.03 | 0.03 |
rsEMG Amplitude (µV) | 10–25 16.3 ± 1.8 | 20–50 31.9 ± 14.4 | 15–50 27.3 ± 5.1 | 15–60 28.0 ± 10.1 | 10–100 28.9 ± 14.2 | 0.01 | 0.02 | 0.02 | 0.01 | |
Lovett (0–5) | 5–5 5.0 | 1–5 1.9 ± 1.4 | 0–5 1.5 ± 1.2 | 0–5 1.5 ± 0.6 | 0–5 1.1 ± 0.9 | 0.009 | 0.009 | 0.009 | 0.008 | |
mcsEMG Amplitude (µV) | 900–3500 1456.9 ± 191.4 | 0–800 245.2 ± 68.1 | 0–1200 273.0 ± 48.6 | 0–3000 345.2 ± 149.1 | 0–900 115.1 ± 61.5 | 0.009 | 0.009 | 0.01 | 0.008 | |
FI (3–0) | 3–3 3.0 | 0–2 1.2 ± 0.6 | 0–2 1.1 ± 0.5 | 0–3 1.1 ± 0.8 | 0–2 0.9 ± 0.5 | 0.009 | 0.008 | 0.008 | 0.008 |
Parameter | MAS | |
---|---|---|
rsEMG | rs | p |
0.752 | 0.009 | |
Lovett | ||
mcsEMG | rs | p |
0.602 | 0.008 | |
MAS | ||
Lovett | rs | p |
−0.502 | 0.03 | |
rsEMG | ||
mcsEMG | rs | p |
−0.504 | 0.008 |
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Leszczyńska, K.; Huber, J. Unveiling the Correlations between Clinical Assessment of Spasticity and Muscle Strength and Neurophysiological Testing of Muscle Activity in Incomplete Spinal Cord Injury Patients: The Importance of a Comprehensive Evaluation. Appl. Sci. 2023, 13, 7609. https://doi.org/10.3390/app13137609
Leszczyńska K, Huber J. Unveiling the Correlations between Clinical Assessment of Spasticity and Muscle Strength and Neurophysiological Testing of Muscle Activity in Incomplete Spinal Cord Injury Patients: The Importance of a Comprehensive Evaluation. Applied Sciences. 2023; 13(13):7609. https://doi.org/10.3390/app13137609
Chicago/Turabian StyleLeszczyńska, Katarzyna, and Juliusz Huber. 2023. "Unveiling the Correlations between Clinical Assessment of Spasticity and Muscle Strength and Neurophysiological Testing of Muscle Activity in Incomplete Spinal Cord Injury Patients: The Importance of a Comprehensive Evaluation" Applied Sciences 13, no. 13: 7609. https://doi.org/10.3390/app13137609