Interrater Reliability of a Modified Ashworth Scale of Muscle Spasticity

Bohannon, Richard W.; Smith, Melissa B.

doi:10.1093/ptj/67.2.206

Cited by 4,609 publications

(2,870 citation statements)

References 7 publications

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“…Muscle tone was evaluated using the 6‐point (0, 1, 1+, 2, 3, 4) Modified Ashworth Scale (MAS) (Bohannon & Smith, 1987), which has been shown to be useful for detecting muscle tone also in stroke patients. Its six points each express a different level of resistance of a relaxed limb to passive stretching (0: normal – 4: complete resistance with no movement).…”

Section: Methodsmentioning

confidence: 99%

Botulinum toxin A modifies nociceptive withdrawal reflex in subacute stroke patients

Alvisi

Serrao²,

Conte

et al. 2018

Brain and Behavior

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ObjectivesThe aims of this study were to evaluate the pattern of the nociceptive withdrawal reflex (NWR) of the upper limb at rest and after injection of Botulinum toxin type A (BoNT‐A) in poststroke subacute hemiparetic patients.MethodsFourteen patients with poststroke subacute hemiparesis underwent clinical and instrumental evaluation and BoNT‐A injection. Painful electrical stimulation was applied to induce the NWR. Baseline EMG activity and NWR recordings (EMG and kinematic response) were performed at T0, one month (T1), and three months (T2) after the BoNT‐A injection, as were Modified Ashworth Scale (MAS) and Functional Independence Measure (FIM) scores.ResultsComparison of results at T0, T1, and T2 revealed significant changes in the MAS score for the elbow (p < 0.001) and wrist joints (p < 0.001) and in the FIM score at T0 and T2. BoNT‐A injection had a significant effect on both NWR amplitude and baseline EMG activity in the posterior deltoid (PD) and flexor carpi radialis (FCR) muscles as well as in all averaged muscles. Analysis of elbow kinematics before and after treatment revealed that the reflex probability rates were significantly higher at T1 and T2 than at T0.ConclusionInjection of BoNT‐A in the subacute phase of stroke can modify both the baseline EMG activity and the NWR‐related EMG responses in the upper limb muscles irrespective of the site of injection; furthermore, the reflex‐mediated defensive mechanical responses, that is, shoulder extension and abduction and elbow flexion, increased after treatment. BoNT‐A injection may be a useful treatment in poststroke spasticity with a potential indirect effect on spinal neurons.

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Section: Methodsmentioning

confidence: 99%

Botulinum toxin A modifies nociceptive withdrawal reflex in subacute stroke patients

Alvisi

Serrao²,

Conte

et al. 2018

Brain and Behavior

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“…During five repetitions of a passive motion within one second, resistance was scored on the following 6-point scale (Bohannon & Smith, 1987): 0 = No increased resistance; 1 = Slightly increased resistance (catch followed by relaxation or minimal resistance at the end of the range of motion); 1+ = Slightly increased resistance (catch followed by minimal resistance throughout less than half of the range of motion); 2 = Clear resistance throughout most of the range of motion; 3 = Strong resistance; passive movement is difficult; 4 = Rigid flexion or extension Catch is the phenomenon that suddenly a strong resistance occurs during a fast passive movement.…”

Section: Modified Ashworth Scale (Mas)mentioning

confidence: 99%

“…Objective outcome measures for flexibility and stiffness are muscle tone or level of spasticity. Bohannon and Smith (1987) introduced the Modified Ashworth Scale (MAS) as a scale for grading spasticity. The MAS is a clinical measure of muscle tone and a nominal-level measure of resistance to passive movement (Pandyan et al, 1999).…”

Section: Introductionmentioning

confidence: 99%

Feasibility, test–retest reliability, and interrater reliability of the Modified Ashworth Scale and Modified Tardieu Scale in persons with profound intellectual and multiple disabilities

Waninge¹,

Rook²,

Dijkhuizen³

et al. 2011

Research in Developmental Disabilities

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“…Table 1 characterizes subjects' clinical presentation, including an impairment scale assessed by International standards for Neurological and Functional Classification of Spinal Cord Injury of the American Spinal Injury Association (ASIA), 7 the modified Ashworth scale 8 and medication. All subjects gave their informed consent prior to their participation.…”

Section: Subjectsmentioning

confidence: 99%

Reflex reciprocal facilitation of antagonist muscles in spinal cord injury

Xia

Rymer

2004

Spinal Cord

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Study Design: Electromyographic study in complete and incomplete spinal cord injury (SCI). Objective: To examine the changes in the pattern of reciprocal inhibition between agonist and antagonist muscles in SCI. Settings: Sensory Motor Performance Program, Rehabilitation Institute of Chicago, IL, USA. Methods: Tendon taps were delivered manually with an instrumented hammer to the tendons of the tibialis anterior and soleus muscle in positions of full-ankle dorsiflexion and plantarflexion in eight subjects with complete SCI and eight subjects with incomplete SCI. Electromyographic activity (EMG) was recorded from ankle dorsiflexor and plantarflexor muscles. Tapping force was also recorded by a force sensor mounted to the tendon hammer, indicating the stimulus onset. Measures of reflex EMG magnitude and reflex latency were obtained for both agonist and antagonist muscles. The ratio of antagonist to agonist EMG was computed based on normalized EMG. Results: Substantial reflex responses occurred in both the stretched muscle and in its antagonist. The reflex in antagonist, which we term 'reciprocal facilitation (RF)', was most evident in subjects with incomplete SCI. The magnitude of RF was consistently greater than reflex responses in agonist muscles under all test conditions. The latency of the RF was comparable to that of monosynaptic reflex response. Conclusions: Following SCI, reciprocal organization of segmental reflexes at the ankle is often partially or completely suppressed, allowing reflex activation in antagonist muscles to be manifested. Possible mechanisms underlying these changes in neural organization are discussed.

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Interrater Reliability of a Modified Ashworth Scale of Muscle Spasticity

Cited by 4,609 publications

References 7 publications

Botulinum toxin A modifies nociceptive withdrawal reflex in subacute stroke patients

Botulinum toxin A modifies nociceptive withdrawal reflex in subacute stroke patients

Feasibility, test–retest reliability, and interrater reliability of the Modified Ashworth Scale and Modified Tardieu Scale in persons with profound intellectual and multiple disabilities

Reflex reciprocal facilitation of antagonist muscles in spinal cord injury

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