Content area

Full text

Reza Rahimzadeh Khiabani [1; 2] and George Mochizuki [3; 4; 5] and Farooq Ismail [1; 6] and Chris Boulias [1; 6] and Chetan P. Phadke [1; 5; 7] and William H. Gage [2; 8]

Academic Editor: David Vaudry

1, Spasticity Research Program, West Park Healthcare Centre, Toronto, ON, Canada, westpark.org

2, School of Kinesiology and Health Science, York University, Toronto, ON, Canada, yorku.ca

3, Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute, Toronto, ON, Canada, sunnybrook.ca

4, Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, ON, Canada, sunnybrook.ca

5, Department of Physical Therapy, University of Toronto, Toronto, ON, Canada, utoronto.ca

6, Division of Physiatry, University of Toronto, Toronto, ON, Canada, utoronto.ca

7, Faculty of Health, York University, Toronto, ON, Canada, yorku.ca

8, Toronto Rehabilitation Institute, Toronto, ON, Canada, torontorehab.on.ca

Received Feb 9, 2017; Revised Jun 29, 2017; Accepted Jul 26, 2017

This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

1. Introduction

Stroke can result in neurological damage of the upper motor neurons (UMNs) leading to spasticity [1], with studies reporting prevalence of poststroke spasticity of up to 43% [2]. Spasticity is one of several clinical signs of UMN injury defined by Lance as “a motor disorder characterized by a velocity dependent increase in tonic stretch reflexes (‘muscle tone’) with exaggerated tendon jerks, resulting from hyperexcitability of the stretch reflex, as one component of upper motor neuron syndrome” [3]. Following stroke, in persons with spasticity, changes in the posture of the upper limbs may result, with excessive internal rotation and adduction of the shoulder, elbow flexion, forearm pronation, wrist flexion, finger flexion, and thumb adduction and flexion [1]. In the lower limbs, spasticity may result in excessive extension, internal rotation and adduction at the hip, plantar flexion and inversion of the ankle, and flexion of the toes [4]. As a result of these changes, it has been well established that individuals with spasticity have great challenges in managing their activities of daily living (ADLs) [1].

A common challenge in persons with stroke is impaired balance control, which affects independence in ADLs [5]. Measures of balance control are related to...
 
   
   
 
           
           
           
           
           
           
 
           
           
           
           
           
           
           
           
           
           
           
           

Show less