Determining consistency of elbow joint threshold angle in elbow flexor muscles with spastic hypertonia

Department of Rehabilitation Medicine, Emory University School of Medicine, Atlanta, GA 30322, USA. steve@spinal.emory.edu.

BACKGROUND AND PURPOSE. Threshold angle, the point in passive range of motion where a muscle response or torque change is elicited, may be a potentially valid measure of hypertonus. Because the relationship of initial muscle length to threshold angle has not been addressed previously, this preliminary study examined whether starting elbow joint position and speed of stretch to elbow flexor muscles affect threshold angle. SUBJECTS. Five subjects with stroke-induced hypertonia of the elbow flexor muscles participated. METHODS. Two starting angles and two designated stretch speeds were applied randomly by a torque motor at each of three testing sessions. RESULTS. Starting angle, subject, and session affected threshold angle. A 90-degree starting angle at a stretch speed of approximately 1.0 radian/s produced the most consistent threshold angles between sessions within subjects, and threshold angle was relatively consistent for some subjects, irrespective of speed. CONCLUSION AND DISCUSSION. If future research indicates that these data can be generalized, the use of threshold angle as a consistent measure of hypertonia will require comparison within individuals, use of a consistent starting angle, and a movement condition of a 90-degree starting angle and an approximate movement speed of 1.0 radian/s across sessions.