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Spasticity and spastic co-contraction are expressions of muscle overactivity that occur in spastic paresis syndrome after a brain injury. The objective of the present pilot study was to improve our understanding of the respective adverse consequences of spasticity and spastic co-contraction on motor disability. In contrary to spasticity, spastic co-contraction is strongly associated with motor impairment in subjects with brain injury. Therapies should be directed toward reducing spastic co-contraction in order to improve motor function.

To elucidate the adverse consequences of spasticity and spastic co-contraction of elbow flexors on motor impairment and upper limb functional limitation.

A pilot case-controlled prospective observational study.

Ten brain-injured adults, and 10 healthy controls.

The co-contraction index was computed from electromyographic recordings of elbow flexors during sub-maximal (25% Maximal Voluntary Contraction) isometric elbow extension. Spasticity was assessed with the Tardieu scale, upper limb limitation using a goniometer during active elbow extension, motor selectivity with the Fugl-Meyer Assessment for the upper limb, and motor function with the Action Research Arm Test.

Greater co-contraction occurred in patients with brain injury compared with controls. In contrast to spasticity, strong associations were found between the co-contraction index, the limitation of active elbow extension, the Fugl-Meyer Assessment, and the Action Research Arm Test.

This pilot study suggests that spastic co-contraction rather than spasticity is an important factor in altered upper limb …