Hamstring spasticity assessment: does the hip flexion angle impact outcomes?

Megan Banky; Ross A Clark; Benjamin F Mentiplay; John H Olver; Gavin Williams

doi:10.1080/09638288.2023.2293991

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Hamstring spasticity assessment: does the hip flexion angle impact outcomes?

Journal article

Peer reviewed

Hamstring spasticity assessment: does the hip flexion angle impact outcomes?

Megan Banky, Ross A Clark, Benjamin F Mentiplay, John H Olver and Gavin Williams

Disability and Rehabilitation, Vol.46(21), pp.5099-5103

2024

DOI: https://doi.org/10.1080/09638288.2023.2293991

PMID: 38100372

Abstract

rehabilitation

gait

outcome assessment

validity

Muscle spasticity

Purpose: Hamstring spasticity is prevalent following neurological injury. The standardized assessment involves passive knee extension, in a position of 90° hip flexion. This creates passive insufficiency of the muscle and lacks ecological validity for walking, whereby the hip typically flexes to a maximum of 40° during swing phase, while the knee extends. This study compared assessment outcomes when completed in 40° and 90° hip flexion. Methods: The Modified Ashworth Scale and Modified Tardieu Scale, were performed on 35 adults with a neurological condition. Each participant was assessed by three assessors, resulting in 105 trials at 40° and 90°. Results: There was a significant increase in the proportion of trials rated as spastic using the Modified Ashworth Scale (p=.012, phi=.27), and Modified Tardieu Scale (p<.001, phi=.36), and the severity of spasticity using the Modified Ashworth Scale (p<.001, effect size (ES)=.50), and Modified Tardieu Scale (p<.001 ES=.47), at 90° hip flexion. The angle of reaction occurred 32° earlier at 90° hip flexion (p<.001, ES = 1.61). Conclusions: Completing hamstring assessments in 40° hip flexion may reduce the passive insufficiency and improve the ecological validity of assessment, for walking. This may assist in the selection of patients requiring intervention, when their goal relates to walking.

Details

Title: Hamstring spasticity assessment: does the hip flexion angle impact outcomes?
Authors: Megan Banky (Corresponding Author) - University of Melbourne
Ross A Clark (Author) - University of the Sunshine Coast, Queensland, School of Health - Public Health
Benjamin F Mentiplay (Author) - La Trobe University
John H Olver (Author) - Epworth Hospital
Gavin Williams (Author) - University of Melbourne
Publication details: Disability and Rehabilitation, Vol.46(21), pp.5099-5103
Publisher: Taylor & Francis
Date published: 2024
DOI: 10.1080/09638288.2023.2293991
ISSN: 1464-5165
PMID: 38100372
Grant note: This research was supported by grants awarded to Dr Banky from the Royal Automobile Club of Victoria (RACV); Epworth Research Institute (ERI); and Physiotherapy Research Fund (PRF).
Organisation Unit: School of Health - Public Health; School of Science, Technology and Engineering; Healthy Ageing Research Cluster
Language: English
Record Identifier: 99984949102621
Output Type: Journal article