{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T14:09:51Z","timestamp":1771250991776,"version":"3.50.1"},"reference-count":99,"publisher":"IOP Publishing","issue":"2","license":[{"start":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T00:00:00Z","timestamp":1771200000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T00:00:00Z","timestamp":1771200000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/iopscience.iop.org\/info\/page\/text-and-data-mining"},{"start":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T00:00:00Z","timestamp":1771200000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/publishingsupport.iopscience.iop.org\/questions\/alternative-author-rights-policies\/"},{"start":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T00:00:00Z","timestamp":1771200000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/publishingsupport.iopscience.iop.org\/questions\/alternative-author-rights-policies\/"}],"content-domain":{"domain":["iopscience.iop.org"],"crossmark-restriction":false},"short-container-title":["Prog. Biomed. Eng."],"published-print":{"date-parts":[[2026,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Spasticity, a type of hypertonia characterized by a velocity-dependent increase in muscle tone, is associated with damage to the brain and\/or spinal cord in different neurological conditions. However, secondary non-neurological factors, such as soft tissue changes, can complicate the assessment and differentiation of the underlying causes. Accurate assessment is crucial for effective treatment planning, with clinicians relying on passive movement to grade the \u2018feel\u2019 of the spastic limb. This review aims to identify and evaluate the feasibility of spasticity models or simulations for clinical teaching. Models based on human spastic limbs were examined, with no restrictions on specific conditions or populations. A comprehensive search of four databases and gray literature was conducted to identify relevant studies. Criteria for inclusion focused on model development, data, and evaluation processes. Study selection and data extraction were carried out by independent reviewers, and data synthesis was performed by systematically mapping model properties, methods, and utility. The quality of the studies was assessed using an adapted framework for health technology assessments. The findings highlight opportunities for the development of simulation models to support training. However, significant limitations to the existing evidence base limit the feasibility of developing spasticity models based on existing literature.<\/jats:p>","DOI":"10.1088\/2516-1091\/ae3aed","type":"journal-article","created":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T22:53:58Z","timestamp":1768949638000},"page":"022001","update-policy":"https:\/\/doi.org\/10.1088\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Modeling spasticity: a systematic review"],"prefix":"10.1088","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-2278-8241","authenticated-orcid":true,"given":"G","family":"Gonz\u00e1lez","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2037-4902","authenticated-orcid":true,"given":"J","family":"Marsden","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2299-3870","authenticated-orcid":true,"given":"A","family":"Besinis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7744-0846","authenticated-orcid":true,"given":"P","family":"Borja","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0149-5477","authenticated-orcid":true,"given":"H","family":"Gunn","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"266","published-online":{"date-parts":[[2026,2,16]]},"reference":[{"key":"prgbae3aedbib1","article-title":"Spasticity","author":"Johns Hopkins Medicine","type":"web-resource"},{"key":"prgbae3aedbib2","article-title":"What is Spasticity","author":"Marsden","year":"2018","type":"book"},{"key":"prgbae3aedbib3","doi-asserted-by":"publisher","first-page":"S3","DOI":"10.1097\/01.PHM.0000141125.28611.3E","type":"journal-article","article-title":"Spasticity: the misunderstood part of the upper motor neuron syndrome","volume":"83","author":"Ivanhoe","year":"2004","journal-title":"Am. J. Phys. Med. Rehabil."},{"key":"prgbae3aedbib4","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/354906","type":"journal-article","article-title":"Pathophysiology of Spasticity: implications for Neurorehabilitation","volume":"2014","author":"Trompetto","year":"2014","journal-title":"Biomed. Res. Int."},{"key":"prgbae3aedbib5","first-page":"423","type":"journal-article","article-title":"Rehabilitation procedures in the management of spasticity","volume":"46","author":"Smania","year":"2010","journal-title":"Eur. J. Phys. Rehabil. Med."},{"key":"prgbae3aedbib6","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1080\/09638280400014683","type":"journal-article","article-title":"Biomechanical approaches applied to the lower and upper limb for the measurement of spasticity: a systematic review of the literature","volume":"27","author":"Wood","year":"2005","journal-title":"Disabil. Rehabil."},{"key":"prgbae3aedbib7","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1007\/s11910-019-0991-2","type":"journal-article","article-title":"Assessment and Measurement of Spasticity in MS: state of the Evidence","volume":"19","author":"Hugos","year":"2019","journal-title":"Curr. Neurol. Neurosci. Rep."},{"key":"prgbae3aedbib8","doi-asserted-by":"publisher","DOI":"10.1177\/0300060519888425","type":"journal-article","article-title":"Advanced quantitative estimation methods for spasticity: a literature review","volume":"48","author":"Luo","year":"2020","journal-title":"J. Int. Med. Res."},{"key":"prgbae3aedbib9","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1186\/1743-0003-5-18","type":"journal-article","article-title":"The relation between Ashworth scores and neuromechanical measurements of spasticity following stroke","volume":"5","author":"Alibiglou","year":"2008","journal-title":"J. Neuroeng. Rehabil."},{"key":"prgbae3aedbib10","doi-asserted-by":"publisher","first-page":"827","DOI":"10.1016\/j.pmrj.2009.08.002","type":"journal-article","article-title":"Spastic hypertonia and movement disorders: pathophysiology, clinical presentation, and quantification","volume":"1","author":"Sheean","year":"2009","journal-title":"Phys. Med. Rehabil."},{"key":"prgbae3aedbib11","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1016\/j.gaitpost.2012.11.003","type":"journal-article","article-title":"A clinical measurement to quantify spasticity in children with cerebral palsy by integration of multidimensional signals","volume":"38","author":"Bar-On","year":"2013","journal-title":"Gait Posture"},{"key":"prgbae3aedbib12","doi-asserted-by":"publisher","first-page":"586","DOI":"10.1111\/dmcn.12141","type":"journal-article","article-title":"Challenges of instrumented spasticity assessment","volume":"55","author":"Desloovere","year":"2013","journal-title":"Dev. Med. Child Neurol."},{"key":"prgbae3aedbib13","doi-asserted-by":"publisher","first-page":"1105","DOI":"10.1177\/0269215508095089","type":"journal-article","article-title":"An investigation into the agreement between clinical, biomechanical and neurophysiological measures of spasticity","volume":"22","author":"Malhotra","year":"2008","journal-title":"Clin. Rehabilitat."},{"key":"prgbae3aedbib14","doi-asserted-by":"publisher","first-page":"35","DOI":"10.4103\/1319-1683.68787","type":"journal-article","article-title":"Simulation-based medical teaching and learning","volume":"17","author":"Al-Elq","year":"2010","journal-title":"J. Family Commun. Med."},{"key":"prgbae3aedbib15","doi-asserted-by":"publisher","first-page":"1185","DOI":"10.12669\/pjms.39.4.7145","type":"journal-article","article-title":"Healthcare simulation: an effective way of learning in health care","volume":"39","author":"Saleem","year":"2023","journal-title":"Pak. J. Med. Sci."},{"key":"prgbae3aedbib16","doi-asserted-by":"publisher","first-page":"348","DOI":"10.4103\/0974-2700.70743","type":"journal-article","article-title":"Simulation-based learning: just like the real thing","volume":"3","author":"Lateef","year":"2010","journal-title":"J. Emerg. Trauma Shock"},{"key":"prgbae3aedbib17","first-page":"84","type":"journal-article","article-title":"Pros and cons of simulation in medical education: a review","volume":"3","author":"Krishnan","year":"2017","journal-title":"Int. J. Med. Health Res."},{"key":"prgbae3aedbib18","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2018\/7437386","type":"journal-article","article-title":"The impact of a new pedagogical intervention on nursing students\u2019 knowledge acquisition in simulation-based learning: a quasi-experimental study","volume":"2018","author":"Haukedal","year":"2018","journal-title":"Nurs. Res. Pract."},{"key":"prgbae3aedbib19","article-title":"Modeling and simulation in the context of health technology assessment: review of existing guidance, future research needs, and validity assessment","author":"Dahabreh","year":"2017","type":"web-resource"},{"key":"prgbae3aedbib20","doi-asserted-by":"publisher","first-page":"90","DOI":"10.1016\/0141-5425(82)90067-X","type":"journal-article","article-title":"Testing and modelling of spasticity","volume":"4","author":"Bajd","year":"1982","journal-title":"J. Biomed. Eng."},{"key":"prgbae3aedbib21","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1016\/0141-5425(84)90003-7","type":"journal-article","article-title":"Pendulum testing of spasticity","volume":"6","author":"Bajd","year":"1984","journal-title":"J. Biomed. Eng."},{"key":"prgbae3aedbib22","doi-asserted-by":"publisher","first-page":"175","DOI":"10.1109\/10.554764","type":"journal-article","article-title":"A dynamic neuromuscular model for describing the pendulum test of spasticity","volume":"44","author":"He","year":"1997","journal-title":"IEEE Trans. Biomed. Eng."},{"key":"prgbae3aedbib23","doi-asserted-by":"publisher","first-page":"1612","DOI":"10.1002\/mus.1196","type":"journal-article","article-title":"A comprehensive model of spastic hypertonia derived from the pendulum test of the leg","volume":"24","author":"Le Cavorzin","year":"2001","journal-title":"Muscle Nerve"},{"key":"prgbae3aedbib24","doi-asserted-by":"publisher","first-page":"671","DOI":"10.1163\/016918610X493534","type":"journal-article","article-title":"Leg-robot for demonstration of spastic movements of brain-injured patients with compact magnetorheological fluid clutch","volume":"24","author":"Kikuchi","year":"2010","journal-title":"Adv. Robot."},{"key":"prgbae3aedbib25","doi-asserted-by":"publisher","first-page":"361","DOI":"10.1109\/TNSRE.2012.2195330","type":"journal-article","article-title":"Development of a haptic elbow spasticity simulator (HESS) for improving accuracy and reliability of clinical assessment of spasticity","volume":"20","author":"Park","year":"2012","journal-title":"IEEE Trans. Neural Syst. Rehabil. Eng."},{"key":"prgbae3aedbib26","doi-asserted-by":"publisher","first-page":"233","DOI":"10.1111\/jebm.12266","type":"journal-article","article-title":"Gray literature: an important resource in systematic reviews","volume":"10","author":"Paez","year":"2017","journal-title":"J. Evid.-Based Med."},{"key":"prgbae3aedbib27","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0138237","type":"journal-article","article-title":"The role of Google Scholar in evidence reviews and its applicability to grey literature searching","volume":"10","author":"Haddaway","year":"2015","journal-title":"PLoS One"},{"key":"prgbae3aedbib28","doi-asserted-by":"publisher","first-page":"210","DOI":"10.1186\/s13643-016-0384-4","type":"journal-article","article-title":"Rayyan\u2014a web and mobile app for systematic reviews","volume":"5","author":"Ouzzani","year":"2016","journal-title":"Syst. Rev."},{"key":"prgbae3aedbib29","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1097\/XEB.0000000000000152","type":"journal-article","article-title":"The development of software to support multiple systematic review types: the Joanna Briggs Institute System for the Unified Management, Assessment and Review of Information (JBI SUMARI)","volume":"17","author":"Munn","year":"2019","journal-title":"Int. J. Evid."},{"key":"prgbae3aedbib30","doi-asserted-by":"publisher","first-page":"104","DOI":"10.1109\/SBEC.1995.514449","type":"conference-proceedings","article-title":"The leg drop pendulum test in spastic cerebral palsy: the addition of active elements to a passive, nonlinear, second order model","author":"Fee","year":"1995"},{"key":"prgbae3aedbib31","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1109\/SBEC.1996.493140","type":"conference-proceedings","article-title":"The leg drop pendulum test in spastic cerebral palsy: artificial feedback around a passive, non-linear, second order plant","author":"Fee","year":"1996"},{"key":"prgbae3aedbib32","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1109\/NEBC.1995.513719","type":"conference-proceedings","article-title":"An active, non-linear, model of the leg drop pendulum test: assessing changes in spastic cerebral palsy","author":"Fee","year":"1995"},{"key":"prgbae3aedbib33","article-title":"Synthesis and systematic maps","author":"UCL","type":"web-resource"},{"key":"prgbae3aedbib34","article-title":"Guidance for the conduct and reporting of modeling and simulation studies in the context of health technology assessment","author":"Dahabreh","year":"2008","type":"book"},{"key":"prgbae3aedbib35","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1007\/BF02443747","type":"journal-article","article-title":"Dynamics of spastic knee joint","volume":"22","author":"Vodovnik","year":"1984","journal-title":"Med. Biol. Eng. Comput."},{"key":"prgbae3aedbib36","first-page":"1","type":"journal-article","article-title":"Modeling and identification of pendular motion of the lower leg in normal and stroke subjects","volume":"19","author":"Li","year":"1999","journal-title":"Chin. J. Med. Biol. Eng."},{"key":"prgbae3aedbib37","doi-asserted-by":"publisher","first-page":"170","DOI":"10.1016\/S1297-9562(01)90028-2","type":"journal-article","article-title":"A computed model of the pendulum test of the leg for routine assessment of spasticity in man","volume":"22","author":"Le Cavorzin","year":"2001","journal-title":"Itbm-rbm"},{"key":"prgbae3aedbib38","doi-asserted-by":"publisher","first-page":"1008","DOI":"10.4028\/www.scientific.net\/KEM.321-323.1008","type":"journal-article","article-title":"Assessment of muscle spasticity by a simple pendulum test and modeling","volume":"321","author":"Jun","year":"2006","journal-title":"Key Eng. Mater."},{"key":"prgbae3aedbib39","first-page":"73","type":"conference-proceedings","article-title":"Stretch reflex system model for spasticity evaluation","volume":"vol 14","author":"Kim","year":"2007"},{"key":"prgbae3aedbib40","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1299\/jbse.6.135","type":"journal-article","article-title":"Modeling and identification of mechanical and reflex properties related to spasticity in stroke patients using multiple pendulum tests","volume":"6","author":"Kim","year":"2011","journal-title":"J. Biomech. Sci. Eng."},{"key":"prgbae3aedbib41","first-page":"1573","type":"conference-proceedings","article-title":"Development of knee joint robot for students becoming therapists\u2014development of training program for skill attainment in manual therapy techniques","author":"Maeda","year":"2012"},{"key":"prgbae3aedbib42","doi-asserted-by":"publisher","first-page":"4403","DOI":"10.1109\/EMBC.2014.6944600","type":"conference-proceedings","article-title":"Estimation of intrinsic joint impedance using quasi-static passive and dynamic methods in individuals with and without Cerebral Palsy","author":"Androwis","year":"2014"},{"key":"prgbae3aedbib43","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1186\/s12984-016-0170-5","type":"journal-article","article-title":"Neuro-musculoskeletal simulation of instrumented contracture and spasticity assessment in children with cerebral palsy","volume":"13","author":"Van Der Krogt","year":"2016","journal-title":"J. Neuroeng. Rehabil."},{"key":"prgbae3aedbib44","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0205763","type":"journal-article","article-title":"Interaction between muscle tone, short-range stiffness and increased sensory feedback gains explains key kinematic features of the pendulum test in spastic cerebral palsy: a simulation study","volume":"13","author":"De Groote","year":"2018","journal-title":"PLoS One"},{"key":"prgbae3aedbib45","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1186\/1743-0003-7-35","type":"journal-article","article-title":"The relation between neuromechanical parameters and Ashworth score in stroke patients","volume":"7","author":"de Vlugt","year":"2010","journal-title":"J. NeuroEng. Rehabil."},{"key":"prgbae3aedbib46","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1016\/j.gaitpost.2015.04.006","type":"journal-article","article-title":"The validity and reliability of modelled neural and tissue properties of the ankle muscles in children with cerebral palsy","volume":"42","author":"Sloot","year":"2015","journal-title":"Gait Posture"},{"key":"prgbae3aedbib47","doi-asserted-by":"publisher","first-page":"209","DOI":"10.1007\/978-4-431-55690-9_40","type":"journal-article","article-title":"Exoskeleton simulator of impaired ankle: simulation of spasticity and clonus","volume":"277","author":"Okumura","year":"2015","journal-title":"Lect. Notes Electr. Eng."},{"key":"prgbae3aedbib48","doi-asserted-by":"publisher","first-page":"102","DOI":"10.1007\/s12555-019-0245-8","type":"journal-article","article-title":"Characterization of spastic ankle flexors based on viscoelastic modeling for accurate diagnosis","volume":"18","author":"Shin","year":"2020","journal-title":"Int. J. Control Autom. Syst."},{"key":"prgbae3aedbib49","doi-asserted-by":"publisher","first-page":"1355","DOI":"10.1109\/ACCESS.2018.2846595","type":"journal-article","article-title":"Clasp-knife model of muscle spasticity for simulation of robot-human interaction","volume":"7","author":"Rosly","year":"2019","journal-title":"IEEE Access"},{"key":"prgbae3aedbib50","article-title":"Developing a robotic spasticity simulator with a robust control strategy to mimic various joints","author":"Ferreira-Pinto","year":"2018","type":"other"},{"key":"prgbae3aedbib51","article-title":"Development and validation of lower-and upper-extremity robotic medical education task trainers for neurologic exams","author":"Pei","year":"2022","type":"other"},{"key":"prgbae3aedbib52","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1109\/TNSRE.2003.819926","type":"journal-article","article-title":"Neuromuscular modeling of spasticity in cerebral palsy","volume":"12","author":"Fee","year":"2004","journal-title":"IEEE Trans. Neural Syst. Rehabil. Eng."},{"key":"prgbae3aedbib53","doi-asserted-by":"publisher","first-page":"418","DOI":"10.1152\/jn.00573.2012","type":"journal-article","article-title":"Simultaneous characterizations of reflex and nonreflex dynamic and static changes in spastic hemiparesis","volume":"110","author":"Zhang","year":"2013","journal-title":"J. Neurophysiol."},{"key":"prgbae3aedbib54","doi-asserted-by":"publisher","first-page":"p 48","DOI":"10.1109\/ICORR.2007.4428405","type":"conference-proceedings","article-title":"Basic research on the upper limb patient simulator","volume":"vol 1 and 2","author":"Fujisawa","year":"2007"},{"key":"prgbae3aedbib55","doi-asserted-by":"publisher","first-page":"475","DOI":"10.1109\/HAPTICS.2008.4479997","type":"conference-proceedings","article-title":"Haptic simulation of elbow joint spasticity","author":"Grow","year":"2008"},{"key":"prgbae3aedbib56","doi-asserted-by":"publisher","first-page":"146","DOI":"10.1109\/ICORR.2017.8009237","type":"conference-proceedings","article-title":"Development of elbow spasticity model for objective training of spasticity assessment of patients post stroke","author":"Park","year":"2017"},{"key":"prgbae3aedbib57","doi-asserted-by":"publisher","first-page":"V001T11A007","DOI":"10.1115\/DMD2018-6881","type":"journal-article","article-title":"Revised design of a passive hydraulic training simulator of biceps spasticity","volume":"40789","author":"Pei","year":"2018"},{"key":"prgbae3aedbib58","doi-asserted-by":"publisher","first-page":"999","DOI":"10.4028\/www.scientific.net\/AMM.393.999","type":"journal-article","article-title":"Emulation of spasticity symptoms in upper limb part-task trainer for physiotherapist education","volume":"393","author":"Zakaria","year":"2013","journal-title":"Appl. Mech. Mater."},{"key":"prgbae3aedbib59","doi-asserted-by":"publisher","DOI":"10.1115\/1.4045845","type":"journal-article","article-title":"Passive hydraulic training simulator for upper arm spasticity","volume":"12","author":"Liang","year":"2020","journal-title":"J. Mech. Robot."},{"key":"prgbae3aedbib60","doi-asserted-by":"publisher","first-page":"328","DOI":"10.1016\/j.procs.2017.01.236","type":"journal-article","article-title":"System integration of an upper limb disorder part-task trainer with PC-based control","volume":"105","author":"Idris","year":"2017","journal-title":"Proc. Comput. Sci."},{"key":"prgbae3aedbib61","doi-asserted-by":"publisher","first-page":"198","DOI":"10.1016\/j.medengphy.2017.06.023","type":"journal-article","article-title":"Neural and non-neural related properties in the spastic wrist flexors: an optimization study","volume":"47","author":"Wang","year":"2017","journal-title":"Med. Eng. Phys."},{"key":"prgbae3aedbib62","doi-asserted-by":"publisher","first-page":"1066","DOI":"10.4028\/www.scientific.net\/KEM.321-323.1066","type":"journal-article","article-title":"Model-based approach for quantitative evaluation of spasticity","volume":"321-323","author":"Hase","year":"2006","journal-title":"Key Eng. Mater."},{"key":"prgbae3aedbib63","doi-asserted-by":"publisher","first-page":"1844","DOI":"10.1109\/CESA.2006.4281938","type":"conference-proceedings","article-title":"A computed model for quantitative evaluation of spasticity in man","volume":"vol 2","author":"Xin","year":"2006"},{"key":"prgbae3aedbib64","article-title":"Modeling and simulation of lower limb spasticity in motor-impaired individuals","author":"Cha","year":"2021","type":"other"},{"key":"prgbae3aedbib65","doi-asserted-by":"publisher","first-page":"1590","DOI":"10.1109\/ICORR.2017.8009475","type":"conference-proceedings","article-title":"A simple tool to measure spasticity in spinal cord injury subjects","volume":"vol 2017","author":"Arami","year":"2017"},{"key":"prgbae3aedbib66","article-title":"Design and evaluation of a passive hydraulic simulator for biceps spasticity","author":"Pei","year":"2018","type":"other"},{"key":"prgbae3aedbib67","doi-asserted-by":"publisher","first-page":"980","DOI":"10.1109\/TBME.2017.2733581","type":"journal-article","article-title":"Modeling of stretch reflex activation considering muscle type","volume":"65","author":"Kang","year":"2018","journal-title":"IEEE Trans. Biomed. Eng."},{"key":"prgbae3aedbib68","doi-asserted-by":"publisher","first-page":"1374","DOI":"10.1016\/j.proeng.2012.07.324","type":"journal-article","article-title":"Design of upper limb patient simulator","volume":"41","author":"Zakaria","year":"2012","journal-title":"Proc. Eng."},{"key":"prgbae3aedbib69","doi-asserted-by":"publisher","first-page":"183","DOI":"10.5772\/58893","type":"journal-article","article-title":"Emulating upper limb disorder for therapy education","volume":"11","author":"Zakaria","year":"2014","journal-title":"Int. J. Adv. Robot. Syst."},{"key":"prgbae3aedbib70","first-page":"1590","type":"other","article-title":"Emulation of muscle tone of upper limb spasticity and rigidity","author":"Zakaria","year":"2013"},{"key":"prgbae3aedbib71","first-page":"2317","type":"conference-proceedings","article-title":"Neuromuscular model for the stretch reflex in passive movement of spastic elbow joint","volume":"vol 20","author":"Feng","year":"1998"},{"key":"prgbae3aedbib72","first-page":"1286","type":"conference-proceedings","article-title":"Evaluation of spasticity in upper limbs of hemiplegic subjects using a mathematical model","volume":"vol 23","author":"Uchiyama","year":"2001"},{"key":"prgbae3aedbib73","doi-asserted-by":"publisher","first-page":"182","DOI":"10.1109\/86.681184","type":"journal-article","article-title":"Stretch reflex sensitivity: effects of postural and muscle length changes","volume":"6","author":"He","year":"1998","journal-title":"IEEE Trans. Neural Syst. Rehabil. Eng."},{"key":"prgbae3aedbib74","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1016\/j.medengphy.2005.03.012","type":"journal-article","article-title":"A neuromusculoskeletal model to simulate the constant angular velocity elbow extension test of spasticity","volume":"28","author":"Koo","year":"2006","journal-title":"Med. Eng. Phys."},{"key":"prgbae3aedbib75","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0208811","type":"journal-article","article-title":"A spasticity model based on feedback from muscle force explains muscle activity during passive stretches and gait in children with cerebral palsy","volume":"13","author":"Falisse","year":"2018","journal-title":"PLoS One"},{"key":"prgbae3aedbib76","doi-asserted-by":"publisher","first-page":"2236","DOI":"10.1109\/IEMBS.1996.646512.","type":"conference-proceedings","article-title":"Effect of posture and muscle stretch on spasticity: a dynamic model study","volume":"vol 5","author":"He","year":"1996"},{"key":"prgbae3aedbib77","doi-asserted-by":"publisher","DOI":"10.1088\/1757-899X\/824\/1\/012013","type":"journal-article","article-title":"Verification of mathematical model for upper limb spasticity with clinical data","volume":"824","author":"Yee","year":"2020","journal-title":"IOP Conf. Ser.: Mater. Sci. Eng."},{"key":"prgbae3aedbib78","doi-asserted-by":"publisher","first-page":"277","DOI":"10.1109\/NEBC.2003.1216102","type":"conference-proceedings","article-title":"A computational model of the spastic behavior the lower limb","author":"Mantilla","year":"2003"},{"key":"prgbae3aedbib79","doi-asserted-by":"publisher","first-page":"617","DOI":"10.1177\/1545968311403494","type":"journal-article","article-title":"Validation of a new biomechanical model to measure muscle tone in spastic muscles","volume":"25","author":"Lindberg","year":"2011","journal-title":"Neurorehabil. Neural Repair"},{"key":"prgbae3aedbib80","doi-asserted-by":"publisher","first-page":"1893","DOI":"10.1109\/ICCAS.2015.7364673","type":"conference-proceedings","article-title":"Spasticity mathematical modelling in compliance with modified ashworth scale and modified tardieu scales","author":"Zakaria","year":"2015"},{"key":"prgbae3aedbib81","doi-asserted-by":"publisher","first-page":"398","DOI":"10.3389\/fnins.2019.00398","type":"journal-article","article-title":"A regression-based framework for quantitative assessment of muscle spasticity using combined EMG and inertial data from wearable sensors","volume":"13","author":"Zhang","year":"2019","journal-title":"Front. Neurosci."},{"key":"prgbae3aedbib82","first-page":"125","type":"other","article-title":"A measure of spasticity based on the exponential fit of the knee joint torque estimated from the goniogram during the pendulum test","author":"Aleksi\u0107","year":"2021"},{"key":"prgbae3aedbib83","doi-asserted-by":"publisher","first-page":"3320","DOI":"10.1109\/TNSRE.2023.3304951","type":"journal-article","article-title":"Modeling, control, and clinical validation of an upper-limb medical education task trainer for elbow spasticity and rigidity assessment","volume":"31","author":"Pei","year":"2023","journal-title":"IEEE Trans. Neural Syst. Rehabil. Eng."},{"key":"prgbae3aedbib84","doi-asserted-by":"publisher","DOI":"10.1115\/1.4033247","type":"journal-article","article-title":"Design and modeling of a passive hydraulic device for muscle spasticity simulation","volume":"10","author":"Liang","year":"2016","journal-title":"J. Med. Devices Trans. ASME"},{"key":"prgbae3aedbib85","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1016\/S0165-0270(03)00169-9","type":"journal-article","article-title":"Linear spring-damper model of the hypertonic elbow: reliability and validity","volume":"128","author":"McCrea","year":"2003","journal-title":"J. Neurosci. Methods"},{"key":"prgbae3aedbib86","doi-asserted-by":"publisher","first-page":"587","DOI":"10.1515\/bmt-2019-0071","type":"journal-article","article-title":"Mathematical model of patella T-reflex and clinical evaluation with Ashworth scales","volume":"65","author":"Bilgin","year":"2020","journal-title":"Biomed. Eng.\u2014Biomed. Tech."},{"key":"prgbae3aedbib87","doi-asserted-by":"publisher","first-page":"906","DOI":"10.1109\/10.83611","type":"journal-article","article-title":"A quantitative analysis of pendular motion of the lower leg in spastic human subjects","volume":"38","author":"Lin","year":"1991","journal-title":"IEEE Trans. Biomed. Eng."},{"key":"prgbae3aedbib88","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1016\/j.clinbiomech.2016.03.012","type":"journal-article","article-title":"Estimation of tissue stiffness, reflex activity, optimal muscle length and slack length in stroke patients using an electromyography driven antagonistic wrist model","volume":"35","author":"De Gooijer-Van De Groep","year":"2016","journal-title":"Clin. Biomech."},{"key":"prgbae3aedbib89","doi-asserted-by":"publisher","first-page":"577","DOI":"10.1016\/j.jelekin.2004.02.002","type":"journal-article","article-title":"Validation of portable muscle tone measurement device for quantifying velocity-dependent properties in elbow spasticity","volume":"14","author":"Lee","year":"2004","journal-title":"J. Electromyogr. Kinesiol."},{"key":"prgbae3aedbib90","doi-asserted-by":"publisher","first-page":"1376","DOI":"10.1541\/ieejeiss.125.1376","type":"journal-article","article-title":"Modeling the step-like response in the upper limbs of hemiplegia subjects for evaluation of spasticity","volume":"125","author":"Uchiyama","year":"2005","journal-title":"IEEJ Trans. Electron. Inf. Syst."},{"key":"prgbae3aedbib91","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1053\/apmr.2003.50066","type":"journal-article","article-title":"The pendulum test for evaluating spasticity of the elbow joint","volume":"84","author":"Lin","year":"2003","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"prgbae3aedbib92","doi-asserted-by":"publisher","first-page":"5076","DOI":"10.1109\/embc.2019.8856613","type":"conference-proceedings","article-title":"A simplified estimation of abnormal reflex torque due to elbow spasticity using neuro-musculoskeletal model","author":"Sung","year":"2019"},{"key":"prgbae3aedbib93","doi-asserted-by":"publisher","first-page":"6612","DOI":"10.1109\/IEMBS.2005.1616017","type":"conference-proceedings","article-title":"Quantitative Evaluation of Spasticity in Upper Limb in Hemiplegic subject using a mathematical model","author":"Uchiyama","year":"2005"},{"key":"prgbae3aedbib94","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1109\/ICORR.2011.5975462","type":"conference-proceedings","article-title":"Haptic recreation of elbow spasticity","author":"Park","year":"2011"},{"key":"prgbae3aedbib95","doi-asserted-by":"publisher","first-page":"1491","DOI":"10.1109\/IEMBS.2003.1279622","type":"conference-proceedings","article-title":"Biomechanical characterization of the stretch reflex activity as an approach to spasticity measurement and modeling-a pilot study","volume":"vol 2","author":"Salazar-Torres","year":"2003"},{"key":"prgbae3aedbib96","article-title":"A design methodology for development of clinically compliant upper limb spasticity part-task trainer","author":"Zakaria","year":"2016","type":"other"},{"key":"prgbae3aedbib97","article-title":"Design of a passive hydraulic simulator for abnormal muscle behavior replication","author":"Liang","year":"2016","type":"other"},{"key":"prgbae3aedbib98","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbiomech.2021.110829","type":"journal-article","article-title":"Multivariable passive ankle impedance in stroke patients: a preliminary study","volume":"130","author":"Coelho","year":"2022","journal-title":"J. Biomech."},{"key":"prgbae3aedbib99","doi-asserted-by":"publisher","first-page":"815","DOI":"10.1114\/1.234","type":"journal-article","article-title":"Reflex torque response to movement of the spastic elbow: theoretical analyses and implications for quantification of spasticity","volume":"27","author":"Schmit","year":"1999","journal-title":"Ann. Biomed. Eng."}],"container-title":["Progress in Biomedical Engineering"],"original-title":[],"link":[{"URL":"https:\/\/iopscience.iop.org\/article\/10.1088\/2516-1091\/ae3aed","content-type":"text\/html","content-version":"am","intended-application":"text-mining"},{"URL":"https:\/\/iopscience.iop.org\/article\/10.1088\/2516-1091\/ae3aed\/pdf","content-type":"application\/pdf","content-version":"am","intended-application":"text-mining"},{"URL":"https:\/\/iopscience.iop.org\/article\/10.1088\/2516-1091\/ae3aed","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/iopscience.iop.org\/article\/10.1088\/2516-1091\/ae3aed\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/iopscience.iop.org\/article\/10.1088\/2516-1091\/ae3aed\/pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/iopscience.iop.org\/article\/10.1088\/2516-1091\/ae3aed\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/iopscience.iop.org\/article\/10.1088\/2516-1091\/ae3aed\/pdf","content-type":"application\/pdf","content-version":"am","intended-application":"similarity-checking"},{"URL":"https:\/\/iopscience.iop.org\/article\/10.1088\/2516-1091\/ae3aed\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T13:18:08Z","timestamp":1771247888000},"score":1,"resource":{"primary":{"URL":"https:\/\/iopscience.iop.org\/article\/10.1088\/2516-1091\/ae3aed"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,16]]},"references-count":99,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,2,16]]},"published-print":{"date-parts":[[2026,6,1]]}},"URL":"https:\/\/doi.org\/10.1088\/2516-1091\/ae3aed","relation":{},"ISSN":["2516-1091"],"issn-type":[{"value":"2516-1091","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,16]]},"assertion":[{"value":"Modeling spasticity: a systematic review","name":"article_title","label":"Article Title"},{"value":"Progress in Biomedical Engineering","name":"journal_title","label":"Journal Title"},{"value":"paper","name":"article_type","label":"Article Type"},{"value":"\u00a9 2026 The Author(s). Published by IOP Publishing Ltd","name":"copyright_information","label":"Copyright Information"},{"value":"2025-04-28","name":"date_received","label":"Date Received","group":{"name":"publication_dates","label":"Publication dates"}},{"value":"2026-01-20","name":"date_accepted","label":"Date Accepted","group":{"name":"publication_dates","label":"Publication dates"}},{"value":"2026-02-16","name":"date_epub","label":"Online publication date","group":{"name":"publication_dates","label":"Publication dates"}}]}}