Objective Assessment of Spasticity by Pendulum Test: a Systematic Review - Engineering Assignment Help

Assignment Task:

Task:

Abstract Background:

Instrumented pendulum test is an objective and repeatable biomechanical method of assessment for spasticity. However, multitude of sensor technologies and plenty of suggested outcome measures, confuse those interested in implementing this method in practice. Lack of a standard agreement on the defnition of experimental setup and outcome measures adds to this ambiguity and causes the results of one study not to be directly attainable by a group that uses a diferent setup. In this systematic review of studies, we aim to reduce the confusion by providing pros and cons of the available choices, and also by standardizing the defnitions.

Methods:

A literature search was conducted for the period of 1950 to the end of 2019 on PubMed, Science Direct, Google Scholar and IEEE explore; with keywords of “pendulum test” and “Spasticity”. Results: Twenty-eight studies with instrumented pendulum test for assessment of spasticity met the inclusion criteria. All the suggested methods of implementation were compared and advantages and disadvantages were provided for each sensor technology. An exhaustive list categorized outcome measures in three groups of angle-based, angular velocity-based, and angular acceleration-based measures with all diferent names and defnitions.

Conclusions:

With the aim of providing standardized methodology with replicable and comparable results, sources of dissimilarity and ambiguity among research strategies were found and explained with the help of graphical representation of pendulum movement stages and corresponding parameters on the angular waveforms. We hope using the provided tables simplify the choices when implementing pendulum test for spasticity evaluation, improve the consistency when reporting the results, and disambiguate inconsistency in the literature. Keywords: Spasticity, Wartenberg pendulum test, Objective assessment, Outcome measure Open Access © The Author(s) 2020. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/ licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. 

Background

Spasticity according to European Tematic Network to Develop Standardized Measures of Spasticity is ‘‘disordered sensory-motor control, resulting from an upper motor neuron lesion, presenting as intermittent or sustained involuntary activation of muscles’’ [1]. Tis complex motor disorder which is caused by diverse sources of upper motor neuron lesions, afects patients with stroke [2], spinal cord injury [3], traumatic brain injury [4], multiple sclerosis [5] and cerebral palsy [6]. Spasticity can create severe pain and hence may negatively afect the quality of life. Spasticity can interfere with movement and can lead to stif, painful joints [7, 8]. Tis disorder afects more than 12 million persons in the world and interferes with the natural movements of the patients [9, 10]. Billions of dollars are spent in pharmaceutical industry to develop anti-spasticity drugs, though lack of repeatable and objective outcome measures hinders the success [8]. It is generally agreed that spasticity is easy to recognize, but not so easy to quantify. Quantitative assessment of spasticity and spasms is crucial in evaluating treatment interventions. Although quantitative clinical scales have been proposed and are currently in use [11–14], but they lack objectivity. Tis means that with lower resolution and repeatability, which are inherent with subjective measures, perceived level of spasticity or its improvement/worsening can contain errors or small changes be unrecognized.

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