Do clinical tests of spasticity accurately reflect muscle function during walking: a systematic review.

Abstract

Spasticity is a highly prevalent impairment following a neurological injury. Historically, spasticity has been shown to have a detrimental impact on function, pain levels, rehabilitation length of stay and mobility. However there is a body of emerging evidence suggesting that spasticity may not have as large an impact on mobility outcomes as previously suggested. This lack of consensus may be due to a disparity between clinical assessment findings and how spasticity manifests during walking. The ecological validity of a scale refers to the relevance of the test result to everyday function and not purely its reflection of a clinical phenomenon. Evaluating whether clinical scales of spasticity accurately reflect muscle function during walking may give an indication of the ecological validity of these scales and provide a stronger justification for their usage in daily practice. The aim of this systematic review was to establish the ecological validity of clinical tests of lower limb spasticity by determining whether the range of motion (ROM) and speed of assessment accurately replicate biomechanics during walking.