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Stop using the Ashworth scale for the assessment of spasticity
  1. Katharina S Sunnerhagen
  1. Correspondence to Dr Katharina S Sunnerhagen, Rehabilitation Medicin, Dübbsgatan 14, 3rd floor, Sahlgrenska University Hospital, Göteborg S-41345, Sweden; ks.sunnerhagen{at}

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Questioning the gold standard of spasticity is almost heresy. This is what Fleuren et al1 have set out to do (see page 46). To understand this, spasticity has to be looked at from different perspectives.

Firstly, spasticity needs to be defined. Spasticity is often defined as a component of the upper motoneuron syndrome, characterised by a velocity dependent increase in tonic stretch reflexes with exaggerated tendon jerks, resulting from hyperexcitability of the stretch reflexes.2 What then is the impact of spasticity? It can affect a person’s needs (hygiene situation, activities of daily living, eating, sex etc, …

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  • Competing interests None.

  • Provenance and Peer review Commissioned; not externally peer reviewed.

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