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Childs Nerv Syst. 2003 Feb;19(2):114-8. Epub 2003 Feb 1.

Lower extremity spasticity as an early marker of ambulatory recovery following traumatic brain injury.

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  • 1The Research Center for Children with Special Health Care Needs, Franciscan Children's Hospital and Rehabilitation Center, 30 Warren Street, Boston, MA 02135, USA. hdumas@fchrc.org



A consecutive series of 107 children and young persons with traumatic brain injury (TBI) admitted to a hospital-based inpatient rehabilitation program was assessed to determine whether lower extremity spasticity could be utilized as an early clinical marker for recovery of ambulation. Presence of spasticity was determined by clinical examination at admission, and the ability to ambulate safely indoors (15.24 m) was evaluated at discharge. Sensitivity, specificity and positive and negative predictive values for spasticity were calculated.


Lower extremity spasticity is a sensitive (71.4%) and specific (81.5%) predictor of the inability to ambulate at discharge. The absence of lower extremity spasticity, however, was a better predictor of ambulation recovery than the presence of spasticity was a predictor of nonambulatory status at hospital discharge.


Implications for spasticity assessment and prognosis in terms of ambulation and recovery are discussed.

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