Gül BALTACI, Güldeniz YILMAZ, Ahmet Özgür ATAY

The outcomes of anterior cruciate ligament reconstructed and rehabilitated knees versus healthy knees: a functional comparison

Amaç: Bu çalışmanın amacı spastik serebral palsili (SP) çocuklarda spastisiteyi değerlendirmede kullanılan Modifiye Ashworth Skalası (MAS) ve Modifiye Tardieu Skalası (MTS) yöntemlerinin gözlemci içi güvenirliğini incelemekti. Çalışma planı: Spastik SP’li 37 olgunun dirsek fleksörleri, el bileği fleksörleri, kalça addüktörleri, hamstringler, gastroknemius ve soleus kasları spastisitenin şiddeti açısından MAS ve MTS ile değerlendirildi. Bulgular: Çalışmanın sonucunda MAS’ın gözlemci içi güvenirliğinin tüm ölçümler için anlamlı olup (p

Spastik serebral palsili çocuklarda spastisiteyi değerlendirmede modifiye Ashworth ve Tardieu skalalarının gözlemci içi güvenirliği

Objective: In this study, we aimed to evaluate and compare the functional performance and muscle strength of cases of ACL reconstruction using bone-patellar tendon-bone graft followed by rehabilitation with those of healthy subjects. Methods: This study included fifteen patients (range: 20 to 35 years) who underwent ACL reconstruction 18 to 24 months previously and a control group of 15 healthy volunteers with similar characteristics. Cases were evaluated with physical examinations, functional tests, subjective scales (Lysholm, Hospital for Special Surgery Knee Score (HSSS), and Tegner activity scale) and isokinetic test. Differences between the reconstruction group and control group were analyzed. Results: Significant differences were found in the activity level of the reconstruction group (p

___

1. Scherzer AL. History, definition and classification of cerebral palsy. In: Scherzer AL, editor. Early diagnosis and interventional therapy in cerebral palsy. New York: Marcel Dekker Inc; 2001. p. 1-26.
2. Koman LA, Smith BP, Shilt JS. Cerebral palsy. Lancet 2004; 363:1619-31.
3. Levitt S. Treatment of cerebral palsy and motor delay. 4th ed. Oxford (UK): Blackwell Publishing; 2004.
4. Priori A, Cogiamanian F, Mrakic-Sposta S. Pathophysiology of spasticity. Neurol Sci 2006;27:S307–9.
5. Peacock WJ. The pathophysiology of spasticity. In: Gage JR, editor. the treatment of gait problems in cerebral palsy. London: Mac Keith Pres; 2004. p. 32-41.
6. Tunç B, Ömerci AR, Yorganc›gil H. Cerebral palsy (Infantile cerebral palsy). [Article in Turkish] SDÜ T›p Fakültesi Dergisi 1994;1:37-42.
7. Livanelio¤lu A, Kerem Günel M. Physiotherapy in cerebral palsy. [Text in Turkish] Ankara: Yeni Özbek Matbaas›; 2009.
8. Alhusaini AA, Dean CM, Crosbie J, Shepherd RB, Lewis J. Evaluation of spasticity in children with cerebral palsy using Ashworth and Tardieu Scales compared with laboratory measures. J Child Neurol 2010;25:1242-7.
9. Alibiglou L, Rymer WZ, Harvey RL, Mirbagheri MM. The relation between Ashworth Scores and neuromechanical measurements of spasticity following stroke. J Neuroeng Rehabil 2008;5:18.
10. Pandyan AD, Price CI, Barnes MP, Johnson GR. A biomechanical investigation into the validity of the modified Ashworth Scale as a measure of elbow spasticity. Clin Rehabil 2003;17:290-3.
11. Ansari NN, Naghdi S, Moammeri H, Jalaie S. Ashworth Scales are unreliable for the assessment of muscle spasticity. Physiother Theory Pract 2006;22:119-25.
12. Craven BC, Morris AR. Modified Ashworth scale reliability for measurement of lower extremity spasticity among patients with SCI. Spinal Cord 2010;48:207-13.
13. Mehrholz J, Wagner K, Meissner D, Grundmann K, Zange C, Koch R, et al. Reliability of the Modified Tardieu Scale and the Modified Ashworth Scale in adult patients with severe brain injury: a comparison study. Clin Rehabil 2005;19:751-9.
14. Yam WK, Leung MS. Interrater reliability of Modified Ashworth Scale and Modified Tardieu Scale in children with spastic cerebral palsy. J Child Neurol 2006;21:1031-5.
15. Fosang AL, Galea MP, McCoy AT, Reddihough DS, Story I. measures of muscle and joint performance in the lower limb of children with cerebral palsy. Dev Med Child Neurol 2003;45:664-70.
16. Patrick E, Ada L. The Tardieu Scale differentiates contracture from spasticity whereas the Ashworth Scale is confounded by it. Clin Rehabil 2006;20:173-82.
17. Bohannon RW, Smith MB. Interrater reliability of a modified Ashworth scale of muscle spasticity. Phys Ther 1987;67: 206-7.
18. Boyd RN, Graham HK. Objective measurement of clinical findings in the use of botulinum toxin type A for the management of children with cerebral palsy. Eur J Neurol 1999;6 (Suppl 4):23-35.
19. Portney LG, Watkins MP. Foundations of clinical research: applications to practice. 2nd ed. Upper Saddle, NJ: Prentice Hall Health; 2000.
20. Clopton N, Dutton J, Featherston T, Grigsby A, Mobley J, Melvin J. Interrater and intrarater reliability of the Modified Ashworth Scale in children with hypertonia. Pediatr Phys Ther 2005;17:268-74.
21. Mutlu A, Livanelioglu A, Günel MK. Reliability of Ashworth and Modified Ashworth scales in children with spastic cerebral palsy. BMC Musculoskelet Disord 2008;9:44.
22. Gregson JM, Leathley MJ, Moore AP, Smith TL, Sharma AK, Watkins CL. Reliability of measurements of muscle tone and muscle power in stroke patients. Age Ageing 2000; 29:223-8.
23. Tederko P, Krasuski M, Czech J, Dargiel A, Garwacka- Jodzis I, Wojciechowska A. Reliability of clinical spasticity measurements in patients with cervical spinal cord injury. Ortop Traumatol Rehabil 2007;9:467-83.
24. Ghotbi N, Olyaei GR, Hadian MR, Ansari NN, Bagheri H. Is there any relationship between the Modified Ashworth Scale Scores and alpha motoneuron excitability indicators? Electromyogr Clin Neurophysiol 2006;46:279-84.
25. Gracies JM, Burke K, Clegg NJ, Browne R, Rushing C, Fehlings D, et al. Reliability of the Tardieu Scale for assessing spasticity in children with cerebral palsy. Arch Phys Med Rehabil 2010;91:421-8.