ArticleJournal of rehabilitation medicine2023
Validity, Intra-Rater Reliability and Normative Data of the Neuroflexor™ Device to Measure Spasticity of the Ankle Plantar Flexors after Stroke.
Article in Journal of rehabilitation medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Clinical and neurophysiological effects of manual acupuncture for upper-limb motor dysfunction after ischemic stroke: a three-arm randomized controlled trial.Frontiers in neurology · 2026Trial
- Good to excellent reliability of instrumented ankle passive resistance and strength measurements in children.Frontiers in pediatrics · 2026Article
- Development and preliminary validation of a multimodal instrument for spasticity quantification using a composite index: A pilot study.PloS one · 2026Article
- A low-cost, open-source device to evaluate limb stiffness in a rabbit model of cerebral palsy.Frontiers in bioengineering and biotechnology · 2025Article
- Exploration of the triceps surae muscle in ambulatory children with cerebral palsy using instrumented measurements of stiffness and diffusion tensor magnetic resonance imaging for muscle architecture.BMC musculoskeletal disorders · 2024Observational
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveQuantification of lower limb spasticity after stroke and the differentiation of neural from passive muscle resistance remain key clinical challenges. The aim of this study was to validate the novel NeuroFlexor foot module, to assess the intrarater reliability of measurements and to identify normative cut-off values.
methodsFifteen patients with chronic stroke with clinical history of spasticity and 18 healthy subjects were examined with the NeuroFlexor foot module at controlled velocities. Elastic, viscous and neural components of passive dorsiflexion resistance were quantified (in Newton, N). The neural component, reflecting stretch reflex mediated resistance, was validated against electromyography activity. A test-retest design with a 2-way random effects model permitted study of intra-rater reliability. Finally, data from 73 healthy subjects were used to establish cutoff values according to mean + 3 standard deviations and receiver operating characteristic curve analysis.
resultsThe neural component was higher in stroke patients, increased with stretch velocity and correlated with electromyography amplitude. Reliability was high for the neural component (intraclass correlation coefficient model 2.1 (ICC2,1) ≥ 0.903) and good for the elastic component (ICC2,1 ≥ 0.898). Cutoff values were identified, and all patients with neural component above the limit presented pathological electromyography amplitude (area under the curve (AUC) = 1.00, sensitivity = 100%, specificity = 100%).
conclusionThe NeuroFlexor may offer a clinically feasible and non-invasive way to objectively quantify lower limb spasticity.
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