The drawing test: A measure of spasticity in subjects with hemiplegia caused by stroke

Paraplegic and hemiplegic subjects often have motor limitations caused by spasticity, that is, the following: 1) decreased dexterity, 2) loss of strength, 3) increased tendon jerks, 4) increased resistance to slower passive muscle stretch, and 5) hyperactive flexion reflexes [Landau, 1980]. Studies applying refined biomechanical and electrophysiological measures have revealed a significant change in the passive properties of the subjects with expressed spasticity [Sinkjær et al., 1993]. Based on such observations, the idea that changes in the intrinsic muscle properties are largely responsible for spastic hypertonia has been accepted [Dietz, 1997]. Other investigators conclude, however, that the major cause of spastic muscle hypertonus is the widely accepted pathological increase in the stretch reflex activity [Ashby et al., 1987].