Akademik Veri Yönetim Sistemi
SPASTICITY AND ITS MANAGEMENT WITH PHYSICAL THERAPY APPLICATIONS WITH MULTIPLE SCLEROSIS PATIENTS, ss.73-106, 2010 (SCI-Expanded)
When spasticity's high incidence, its negative effects and the subsequent costs for health care are considered, it is obvious that there is a profound need for accurate evaluation and quantification of spasticity. In order to choose the right technique among several, it is vital to detect the objective of assessment and define the aspects of spasticity needed to be evaluated. Assessment of a spastic patient should be initiated with anamnesis and observation. Muscle test, deep tendon reflexes, pathological reflexes and the measurement of passive and active ROM are important components in the process of evaluating spasticity. There are three primary techniques used for the quantitative measurement of spasticity (clinical scales, neurophysiological and biomechanical evaluations); but when a thorough evaluation is required, secondary measurement techniques may be of use alongside with primary ones. Despite their crucial limitations, both AS and MAS are still regarded as "golden standards" and widely preferred by clinicians for a clinical scale. Stretching reflex, tendon taps reflex (T reflex) and Hoffmann reflex (H reflex) take place in neurophysiological evaluation, and they are important reflexes exposing the increased EMG response in spastic patient's pendulum test and isokinetic dynamometer. They are quite reliable methods, but because of their unfunctional application, they are not widely used in clinics. EDSS, Barthel index, Functional Independence Measurement, Functional Assessment Measurement, quality of life tests (i.e., SF-36, Nottingham Health Profile) are secondary measurements to be used alongside with primary ones.