Intro
Foreword
Preface
Contents
Contributors
Part I: Pathophysiology and Assessment
1: Neural Basis of Spasticity
Definition of Spasticity
Time Course of the Development of Spasticity
What Types of Neural Injury Lead to the Development of Spasticity?
How Does Injury to the Corticospinal Tract Lead to Spasticity?
Consequences of Excitatory-Inhibitory Imbalance in Spinal Circuitry
Conclusion
References
2: Spasticity Versus Spastic Movement Disorder
Introduction
Pathophysiology
Clinical Aspects
Functional Aspects
Implications for Treatment

Conclusion
References
3: Clinical Assessment of the Syndrome of Spastic Paresis
Introduction
Assessment of Spasticity
Ashworth-Derived Scales
The Tardieu Scale
The Syndrome of Spastic Paresis
The Non-Neural Muscle Disorder: Spastic Myopathy
The Neural Disorder
Muscle Overactivity in Antagonists
Stretch-Sensitive Paresis in Agonists
The Five-Step Assessment
Functional Step: Step 1
Technical Steps: Steps 2-5
Conclusion
References
4: Quantitative Measurement of Resistance to Passive Joint Motion in Chronic Stroke Survivors
Introduction

Quantification of Neural and Biomechanical Responses During Elbow Joint Rotation
Determination of Catch Angle and EMG Response
Occurrence of a Catch
EMG Onset Angle
Catch Angle and Reflex EMG Response as a Function of Joint Rotation Speed
Timing of the Onset of the EMG Response and the Catch Angle
Origins of the Resistance to Passive Joint Motion
Quantification of the Resistance to Passive Joint Rotation After BoNT Injections in Chronic Stroke Survivors
Conclusions
References
5: Structural Alterations in Muscle in Children with Spastic Cerebral Palsy

Skeletal Muscle Structure
Change in Muscle Structure During Postnatal Development
Muscle Adaptation
Clinical Presentation in Children with Cerebral Palsy
Sarcomere Alterations in Contractured Muscles
Extracellular Matrix
Alterations in Extracellular Matrix Content
Alterations in Passive Muscle Stiffness
Muscle Stem Cells
Satellite Cells
Change in Satellite Cells in Contractured Muscles
Metabolic Properties
Alterations in Motor Units and in the Neuromuscular Junction
Conclusion
References

6: Mechanisms of Development of Passive Mechanical Muscle Stiffness
Introduction
Three-dimensional Muscle Geometry and its Effect on Active and Passive Force Generation
The Architecture of Muscle Affects its Force Generating Capacity
The ECM Transmits Force Laterally and Facilitates Muscle Shape Changes
The Three-dimensional Nature of Muscle Contraction
Effect of Fluid-ECM Interactions on Muscle Mechanics
Role of Intramuscular Fluid on the Properties of the ECM
Intramuscular Fluid Affects the Viscosity of the Ground Substance of the ECM