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Research Article  |   July 1996
Reliability of Potential Clinical Measures of Muscle Tone in the Elbows of Patients After Stroke
Author Affiliations
  • J. Scott Worley, MA, OTR/L, is Associate Professor, Department of Occupational Therapy, School of Allied Health Sciences, East Carolina University, Greenville, North Carolina 27858
  • Nan Harmon, MS, OTR/L, is Occupational Therapist, Spectrum Center, Bethesda, Maryland. At the time of this study, she was Staff Therapist, Department of Occupational Therapy, Pitt County Memorial Hospital, Greenville, North Carolina
  • Georganna J. Miller, MEd, OTR/L, is Assistant Professor and Academic Fieldwork Coordinator, Department of Occupational Therapy, Xavier University, Cincinnati, Ohio
  • Sharon Bowen Hollis, OTR/L, is Staff Therapist, Department of Occupational Therapy, Pitt County Memorial Hospital, Greenville, North Carolina
  • Sue Harlow, OTR/L, is Supervisor, Occupational Therapy, Good Samaritan Hospital, Cincinnati, Ohio
  • Vickie Briggs, OTR/L, is Occupational Therapist, Bethesda Montgomery Center, Cincinnati, Ohio. At the time of this study, she was Staff Therapist, Occupational Therapy, Good Samaritan Hospital, Cincinnati, Ohio
Article Information
Neurologic Conditions / Stroke / Research
Research Article   |   July 1996
Reliability of Potential Clinical Measures of Muscle Tone in the Elbows of Patients After Stroke
American Journal of Occupational Therapy, July/August 1996, Vol. 50, 554-560. doi:10.5014/ajot.50.7.554
American Journal of Occupational Therapy, July/August 1996, Vol. 50, 554-560. doi:10.5014/ajot.50.7.554
Abstract

Objectives. This study investigated the reliability of joint resting position (EJP), resistance to passive movement (ERM), and the angle of appearance of the resistance (EAR) as measures of muscle hypertonus of elbow flexors in patients after stroke. Previously, similar measures had been found reliable when applied to measuring shoulder and wrist hypertonus in patients after stroke.

Method. Forty-five subjects with stroke were randomly selected from occupational therapy admissions at two rehabilitation centers. Tone of elbow flexors was measured twice at the same sitting by two examiners. EJP and EAR were measured with a goniometer, and ERM was measured with a resistance rating scale. Correlations were calculated between first and second measurements by center and by high tone and poor upper extremity function subgroups (with correction for multiple correlations) to determine reliability.

Results. Each of the three measures was highly reliable as demonstrated by a high correlation in at least one of the subgroups (Center 1: EJP, r =.964 for high tone subgroup; ERM, r =.789, EAR, r =.902, both in poor upper extremity function subgroup; and Center 2: EJP, r =.892, ERM, r =.938, both in poor upper extremity function subgroup; EAR, r =.666 for all subjects; all p values < .05). Correlations were especially high when data for subjects with high upper extremity function were eliminated.

Conclusion. Reliability of these three methods of measuring upper extremity muscle tone enhances their usefullness as well as therapists’ confidence in their judicial application.