{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:07:54Z","timestamp":1791331674888,"version":"4.3.1"},"reference-count":34,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[1999,3]]},"abstract":"<jats:p>\n            <jats:italic>Background and Purpose<\/jats:italic>\n            \u2014The aim of this study was to assess the role of knee and ankle extensor overactivity in the hemiplegic gait observed in stroke victims and to propose a clinical guide for selecting patients before treatment of a supposed disabling spasticity.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Methods<\/jats:italic>\n            \u2014A standardized physical examination procedure was performed in 135 consecutive stroke patients. All patients were able to walk without human assistance. The period after stroke ranged from 3 to 24 months (mean, 11.5\u00b17.25 months). Spasticity was evaluated with the stroke victim in sitting position and during walking. Overactivity of the quadriceps was considered disabling when inducing inability to flex the knee during the swing phase despite adequate control of knee flexion in sitting and standing positions; overactivity of the triceps surae was considered to be disabling when heel strike was not possible despite good control of the ankle flexion in sitting position; triceps retraction was also considered.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Results<\/jats:italic>\n            \u2014Disabling overactivity was observed in 56 (41.5%) patients: 11 times for the quadriceps femoris, 21 times for the triceps surae, and 21 times for both muscles. It was considered to be the main disorder impairing gait among only 16 (12%) patients: 9 for the quadriceps alone, 3 for the triceps alone, and 4 for both. Sitting spasticity of the lower limb was not predictive of disabling overactivity during walking.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Conclusions<\/jats:italic>\n            \u2014Extensor muscle overactivity is one of the components of gait disorders in stroke patients. The difficulty in assessing spasticity and its real causal effect in gait disturbances are discussed. A clinical guide is proposed.\n          <\/jats:p>","DOI":"10.1161\/01.str.30.3.580","type":"journal-article","created":{"date-parts":[[2011,6,17]],"date-time":"2011-06-17T20:08:03Z","timestamp":1308341283000},"page":"580-585","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":57,"title":["A Clinical Guide to Assess the Role of Lower Limb Extensor Overactivity in Hemiplegic Gait Disorders"],"prefix":"10.1161","volume":"30","author":[{"given":"A.","family":"Yelnik","sequence":"first","affiliation":[{"name":"From the Physical Medicine and Rehabilitation Department, GH Lariboisie\u0300re\u2013F. Widal, Paris, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Albert","sequence":"additional","affiliation":[{"name":"From the Physical Medicine and Rehabilitation Department, GH Lariboisie\u0300re\u2013F. Widal, Paris, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I.","family":"Bonan","sequence":"additional","affiliation":[{"name":"From the Physical Medicine and Rehabilitation Department, GH Lariboisie\u0300re\u2013F. Widal, Paris, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I.","family":"Laffont","sequence":"additional","affiliation":[{"name":"From the Physical Medicine and Rehabilitation Department, GH Lariboisie\u0300re\u2013F. Widal, Paris, France."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_1_2","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/102.2.405"},{"key":"e_1_3_1_2_2","first-page":"47","volume":"131","year":"1978","unstructured":"Perry J, Waters RL, Perrin T. Electromyographic analysis of equinovarus following stroke. Clin Orthop Rel Res. 1978;131:47\u201353.","journal-title":"Clin Orthop Rel Res"},{"key":"e_1_3_1_3_2","first-page":"71","volume":"131","year":"1978","unstructured":"Perry J, Giovan P, Harris LJ, Montgomery J, Azaria M. The determinants of muscle action in the hemiparetic lower extremity. Clin Orthop Rel Res. 1978;131:71\u201389.","journal-title":"Clin Orthop Rel Res"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/119.5.1737"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-9993(96)90138-0"},{"key":"e_1_3_1_6_2","first-page":"4","volume":"73","year":"1992","unstructured":"Katrak PH, Cole AMD, Poulos CJ, McCauley JCK. Objective assessment of spasticity, strength and function with early exhibition of dantrolene sodium after cerebrovascular accident: a randomized double-blind study. Arch Phys Med Rehabil. 1992;73:4\u20139.","journal-title":"Arch Phys Med Rehabil"},{"key":"e_1_3_1_7_2","first-page":"300","volume":"74","year":"1993","unstructured":"Price R, Lehmann JF, Boswell-Bessette S, Burleigh A, De Lateur BJ. Influence of cryotherapy on spasticity at the human ankle. Arch Phys Med Rehabil. 1993;74:300\u2013304.","journal-title":"Arch Phys Med Rehabil"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF01411279"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.63.5.575"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1227\/00006123-198812000-00009"},{"key":"e_1_3_1_11_2","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1007\/BF00812153","volume":"239","year":"1992","unstructured":"Dengler R, Neyer U, Wohlfarth K, Bettig U, Janzik HH. Local botulinum toxin in the treatment of spastic drop foot. J Neurol. 1992;239:375\u2013378.","journal-title":"J Neurol"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.58.2.232"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.57.11.1321"},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-9993(96)90015-5"},{"key":"e_1_3_1_15_2","doi-asserted-by":"publisher","DOI":"10.2340\/1650197771331"},{"key":"e_1_3_1_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/0141-5425(84)90003-7"},{"key":"e_1_3_1_17_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.1.1.18"},{"key":"e_1_3_1_18_2","unstructured":"Denny-Brown D. The basal ganglia and their relation to disorders of movement. London UK: Oxford University Press; 1962."},{"key":"e_1_3_1_19_2","first-page":"540","volume":"192","year":"1964","unstructured":"Ashworth B. Preliminary trial of carisoprodol in multiple sclerosis. Practitioner.. 1964;192:540\u2013542.","journal-title":"Practitioner."},{"key":"e_1_3_1_20_2","doi-asserted-by":"publisher","DOI":"10.1093\/ptj\/67.2.206"},{"key":"e_1_3_1_21_2","doi-asserted-by":"publisher","DOI":"10.1097\/00004356-199206000-00009"},{"key":"e_1_3_1_22_2","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/104.3.431"},{"key":"e_1_3_1_23_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.48.7.676"},{"key":"e_1_3_1_24_2","first-page":"214","volume":"78","year":"1982","unstructured":"Tardieu C, Tabary JC, Tabary C, Tardieu G. Adaptation of connective tissue length to immobilization in the lengthened and shortened positions in cat soleus muscle. J Physiol (Paris).. 1982;78:214\u2013220.","journal-title":"J Physiol (Paris)."},{"key":"e_1_3_1_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-9993(98)90294-5"},{"key":"e_1_3_1_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/0003-9993(92)90007-J"},{"key":"e_1_3_1_27_2","first-page":"233","volume":"114","year":"1991","unstructured":"Thilmann AF, Fellows SJ, Garms E. The mechanism of spastic muscle hypertonus. Brain. 1991;114:233\u2013244.","journal-title":"Brain"},{"key":"e_1_3_1_28_2","first-page":"438","volume":"42","year":"1997","unstructured":"Gracies JM, Wilson L, Gandevia SC, Burke D. Stretched position of spastic muscles aggravates their cocontraction in hemiplegic patients. Ann Neurol. 1997;42:438\u2013439.","journal-title":"Neurol"},{"key":"e_1_3_1_29_2","first-page":"777","volume":"68","year":"1987","unstructured":"Bohannon RW. Gait performance of hemiparetic stroke patients: selected variables. Arch Phys Med Rehabil. 1987;68:777\u2013781.","journal-title":"Arch Phys Med Rehabil"},{"key":"e_1_3_1_30_2","first-page":"330","volume":"71","year":"1990","unstructured":"Bohannon RW, Andrews AW. Correlation of knee extensor muscle torque and spasticity with gait speed in patients with stroke. Arch Phys Med Rehabil. 1990;71:330\u2013333.","journal-title":"Arch Phys Med Rehabil"},{"key":"e_1_3_1_31_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.410020604"},{"key":"e_1_3_1_32_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.1975.tb00386.x"},{"key":"e_1_3_1_33_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-9993(96)90073-8"},{"key":"e_1_3_1_34_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-6054(97)83590-8"}],"container-title":["Stroke"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/01.STR.30.3.580","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,12]],"date-time":"2024-05-12T22:02:55Z","timestamp":1715551375000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/01.STR.30.3.580"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1999,3]]},"references-count":34,"journal-issue":{"issue":"3","published-print":{"date-parts":[[1999,3]]}},"alternative-id":["10.1161\/01.STR.30.3.580"],"URL":"https:\/\/doi.org\/10.1161\/01.str.30.3.580","relation":{},"ISSN":["0039-2499","1524-4628"],"issn-type":[{"value":"0039-2499","type":"print"},{"value":"1524-4628","type":"electronic"}],"subject":[],"published":{"date-parts":[[1999,3]]},"assertion":[{"value":"1998-05-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"1998-12-15","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"1999-03-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}