ASSESSMENT OF SPASTICITY IN HEMIPLEGIC CEREBRAL-PALSY .2. DISTAL LOWER-LIMB REFLEX EXCITABILITY AND FUNCTION

A clinical method for measuring the stretch reflex theshold and gain o f muscles acting across the ankle joint in children with congenital he miplegia is described. The stretch reflexes of all limbs were velocity -dependent. Hemiparetic limbs were not necessarily spastic compared wi th non-paretic limbs, suggesting that the term 'spastic hemiplegia' sh ould be used more selectively and emphasis be placed on the heterogene ity of the hemisyndromes of childhood. Abnormal motor control, plannin g and dexterity, the hemipostures and plastic (non-electrical) muscle changes may be more important measures of impairment than reflex excit ability. A general scheme for assessing reflex excitability and availa ble treatments applicable to all types of cerebral palsy is proposed.