How is a physical and occupational therapy evaluation of spasticity administered?

Updated: Jun 28, 2019
  • Author: Krupa Pandey, MD; Chief Editor: Stephen A Berman, MD, PhD, MBA  more...
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Standardized assessments for motor control that can be tested for validity and reliability have yet to be devised for use in the patient with neurologic deficits. Because the assessment measures themselves may influence tone, running the testing series in the same order each time is important. Muscle tone should be assessed before any functional assessments. The upper extremity is evaluated in the sitting position, and the shoulder rotators, pronators, supinators, wrist flexors/extensors, and finger flexors are assessed with the elbow in 90° of flexion. Other muscle groups are assessed with the elbow extended.

The patient is placed in the supine position for assessment of all muscle groups of the lower extremity except the knee flexors. The patient is then moved to the prone position for assessment of the right, and then left, knee flexors. The Modified Ashworth Scale assessment should be followed by the Bilateral Adductor Tone measure, if required. Goniometric measurements for active and passive ranges of movement follow muscle tone assessment.

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