Assessment of spasticity after stroke using clinical measures: A systematic review

Abstract

Purpose: To identify and appraise the literature on clinical measures of spasticity that has been investigated in people after stroke. Methods: The literature search involved four databases (PubMed, CINAHL, Embase and The Cochrane Library) up to February 2014. The selected studies included those that aimed to measure spasticity using a clinical assessment tool among adult patients post-stroke. Two independent raters reviewed the included articles using a critical appraisal scale and a structured data extraction form. Results: A total of 40 studies examining 15 spasticity assessment tools in patients post-stroke were reviewed. None of the reviewed measurement tools demonstrated satisfactory results for all psychometric properties evaluated, and the majority lacked evidence concerning validity and absolute reliability. Conclusion: This systematic review found limited evidence to support the use of most of clinical measures of spasticity for people post-stroke. Future research examining the application and psychometric properties of these measures is warranted. ▸ Implications for Rehabilitation • There is a need for objective clinical tools for measuring spasticity that are clinically feasible and easily interpreted by clinicians. • This review identified various clinical measures of spasticity that have been investigated in people after stroke. • Insufficient evidence of psychometric properties precludes recommending one tool over the others. • Future research should focus on investigating the psychometric properties of clinical measures of spasticity.