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Spasticity is a disabling problem for many adults and children with a variety of neurological disorders such as multiple sclerosis, stroke, cerebral palsy and traumatic brain injury. A practical guide for clinicians involved in the management of spasticity, this book covers all aspects of upper motor neurone syndrome from basic neurophysiology and measurement techniques to practical therapy and the use of orthoses. Surgical techniques are also covered, as well as the particular problems of management of spasticity in childhood. In the second edition of this key text, all chapters have been thoroughly updated, with additional coverage of new techniques and new drugs and therapies, whilst continuing the format that has made the first edition the core text in its field. This guide will be invaluable to physicians, physiotherapists, surgeons, orthotists, clinical engineers and health professionals.
Michael P. Barnes, Professor of Neurological Rehabilitation Walkergate Park International Centre for Neurorehabilitation and Neuropsychiatry, Newcastle upon Tyne, UK,
Garth R. Johnson, Professor of Rehabilitation Engineering Centre for Rehabilitation and Engineering Studies (CREST) School of Mechanical and Systems Engineering Newcastle University Newcastle upon Tyne, UK
The first edition of this textbook provided a practical guide and source of references for physicians, surgeons, therapists, orthotists, engineers and other health professionals who are involved in the management of the disabled person with spasticity. The second edition follows the same format. We have updated the chapters and provided new references and described new techniques. We hope we have covered all aspects of management from physiotherapy, seating and positioning and orthoses to the use of drugs, intrathecal techniques and surgery. We have also stressed the importance of adequate measurement techniques and, indeed, Chapter 3 has been completely rewritten by Garth R. Johnson and Arnand D. Pandyan. We hope that clinicians will continue to find this book helpful and a useful source of reference in their own practise and that it will continue to provide a solid base for a greater understanding of the management of spasticity.
Garth R. Johnson, Professor of Rehabilitation Engineering Centre for Rehabilitation and Engineering Studies (CREST) School of Mechanical and Systems Engineering Newcastle University Newcastle upon Tyne, UK,
Anand D. Pandyan, School of Health & Rehabilitation/Institute for Life Course Studies, Keele University, Staffordshire, UK
Even today the measurement of spasticity at the level of impairment is probably in its infancy. Due to the lack of treatment or therapy to reduce spasticity, there has been limited development of methods for its measurement. There are four distinct levels of measurement that can be identified hierarchically as follows: nominal, ordinal, interval and ratio levels. Following the original research of Tardieu and colleagues in the early 1950s, a new scale for classifying spasticity based was developed. This scale has since been translated to English and undergone substantial modifications. The Tardieu method of assessment provides a composite measure of spasticity. The quality of the muscle reaction is a categorical level of measurement and therefore can primarily used for classification purposes only. There are two elements to be considered when exploring the reliability of the Tardieu scale.