Hacker et al reported a bedside screening test to identify a patient with spasticity who should be referred to a spasticity specialist. The authors are from Vanderbilt University, Florida State University, and the University of Chicago.
Patient selection: older adult with spasticity
Outcome: referral to a spasticity specialist
Parameters:
(1) weakness in any of the limbs
(2) abnormal posture in any of the limbs
(3) resistance to passive movement of the affected limb
Abnormal postures include:
(1) clenched fist
(2) bent wrist
(3) flexed elbow
(4) internally rotated shoulder
(5) knees pressed together
(6) inward turning at the ankles
(7) walking on the ball of the foot
Weakness
Abnormal Posture
Resistance to Passive Movement
Referral
no
NA
NA
no
yes
yes
NA
yes
yes
no
no
no
yes
no
yes
yes
Performance:
• The area under the ROC curves is 0.84 (for PCP).
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