Grant recipient: Dr Megan Banky MACP 

Project title: Establishing the impact of a controlled testing speed on spasticity outcomes: clinical assessment tool implications

Year awarded: 2021

Grant: Pat Cosh Trust Grant

Grant amount: $19,932.04 

Snapshot: Spasticity is an abnormal increase in muscle tightness, which is common following neurological injury such as stroke and traumatic brain injury. Spasticity has been shown to have a profound impact on an individual’s independence, quality of life and rehabilitation length of stay. The main goal reported by patients in this population is to return to independent, normal walking. Yet despite this, there is a lack of consensus in the research regarding the relationship between spasticity and walking outcomes. 
The aim of this study, supported by the Pat Cosh Foundation, was to determine whether completing a spasticity assessment (Modified Tardieu Scale) matched to an individual patient’s walking speed alters the assessment findings, when compared to its standardised form. It was anticipated that this would provide a greater understanding of the relationship between spasticity and walking performance, leading to improved patient outcomes and optimal use of medical resources. 
Seventy participants with a neurological condition were recruited, based on a power calculation completed with a bio-statisticians input. Each participant attended one assessment session. Two user-friendly, previously validated sensors (Figure 1) were used to collect data pertaining to testing speed and joint angles. The assessment was completed unilaterally on the main four leg muscles; in the calf (gastrocnemius and soleus) and the thigh (hamstrings and quadriceps), which are paramount for walking and are frequently the focus of spasticity intervention.

The findings: Participant demographics and walking speed: The average age of the 70 participants recruited was 42.6 years old, 41 were male, and 29 female. In regards to diagnosis, 21 participants had suffered a stroke, 26 a traumatic brain injury (TBI), 11 had Multiple Sclerosis, and 12 participants had other neurological diagnoses such as neurosurgery or neurological cancer. The median time since diagnosis or injury was 3.5 months (range 1-456). The average walking speed was 0.89m/s, indicative of a relatively mobile cohort. Only 22 (31.4%) participants required a gait aid to walk 10m.

Benefits to the profession: As anticipated, the results of this study will provide exciting developments for 1) clinical practice, 2) future research projects; and 3) further staff development.

The next steps:  The future of this research aims to make the MTS a more functionally relevant assessment tool.

Read more about Megan’s research in InMotion.