Present problem of neurororehabilitology: methods for quantitative assessment of pathological increased muscle tone

Abstract

One of the urgent problems of neurorehabilitation is spasticity ― a motor disorder that depends on the rate of muscle stretching due to the enhancement of tonic stretch reflexes due to a violation of supraspinal inhibitory signals, which is manifested by intermittent or prolonged involuntary muscle activation. In addition to spasticity, the clinical forms of lesions of the upper motor neurons in the form of muscle hypertonicity include rigidity and dystonia. Although spasticity is one of the most common occurrences, its precise definition and pathophysiology remain unclear. Spasticity reduces the effectiveness of rehabilitation of patients with severe disabling diseases. With organic lesions of the brain, movement disorders are often caused by increased muscle tone, which makes it difficult to perform simple movements. For the correct setting of treatment goals for a patient with spasticity syndrome, including for the development of an individual rehabilitation program with a further assessment of its effectiveness, it is necessary to correctly determine the spasticity and its severity, differentiate from other forms of pathological changes in muscle tone (rigidity, plasticity, contractures), as well as to assess the impact on the active and passive function of the limb, daily life and quality of life of the patient. An important issue in the rehabilitation process is the method of quantitative assessment of the pathological increase in muscle tone, for which the collection of complaints and anamnesis, physical neurological examination, scales and various options for instrumental examination are used. The review article presents modern and traditional methods for quantifying muscle tone, as well as methods of therapy.