Reliability of the tone assessment scale and the modified ashworth scale as clinical tools for assessing poststroke spasticity

Gregson, J M; Leathley, Michael J; Moore, Andrew R.; Sharma, Anil Kumar; Smith, T L; Watkins, Caroline

doi:10.1016/s0003-9993(99)90053-9

Cited by 349 publications

(249 citation statements)

References 10 publications

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“…In the study of Gregson et al (1999), which involved poststroke patients, the kappa score for interrater reliability was 0.84 and for intrarater reliability was 0.83, which is comparable to the quadratically weighted kappa scores of the present study.…”

Section: Discussionsupporting

confidence: 83%

“…The reliability of the scale appears to be better for measuring muscle tone of upper limbs (Pandyan et al, 1999). Although one study found the reliability of the MAS to be very good (kappa was 0.84 for interrater and 0.83 for intrarater comparisons) (Gregson, Leathley, Moore, Sharma, Smith, & Watkins, 1999), other studies found it to be insufficient (Ansari, Naghdi, Arab, & Jalaie, 2008;Clopton et al, 2005;Mutlu, Livanelioglu, & Gunel, 2008;Yam & Leung, 2006). Haugh, Pandayan, and Johnson (2006) suggested that the Modified Tardieu Scale (MTS) is a more appropriate clinical measure of spasticity than the MAS.…”

Section: Introductionmentioning

confidence: 98%

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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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Section: Discussionsupporting

confidence: 83%

Section: Introductionmentioning

confidence: 98%

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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“…Such measures include the pendulum test, 33 the modified Ashworth scale, 34 -36 and others. 37 Such scales could be applied to hypertonia as a result of spasticity, dystonia, or rigidity but do not differentiate between them. 38 The Tardieu scale explicitly compares the occurrence of a catch at low and high speeds and therefore is effective in measuring the velocity-dependent component of hypertonia.…”

Section: Measures Of Severitymentioning

confidence: 99%

Classification and Definition of Disorders Causing Hypertonia in Childhood

et al. 2003

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ABSTRACT.Objective. This report describes the consensus outcome of an interdisciplinary workshop that was held at the National Institutes of Health in April 2001. The purpose of the workshop and this article are to define the terms "spasticity," "dystonia," and "rigidity" as they are used to describe clinical features of hypertonia in children. The definitions presented here are designed to allow differentiation of clinical features even when more than 1 is present simultaneously.Methods. A consensus agreement was obtained on the best current definitions and their application in clinical situations.Results. "Spasticity" is defined as hypertonia in which 1 or both of the following signs are present: 1) resistance to externally imposed movement increases with increasing speed of stretch and varies with the direction of joint movement, and/or 2) resistance to externally imposed movement rises rapidly above a threshold speed or joint angle. "Dystonia" is defined as a movement disorder in which involuntary sustained or intermittent muscle contractions cause twisting and repetitive movements, abnormal postures, or both. "Rigidity" is defined as hypertonia in which all of the following are true: 1) the resistance to externally imposed joint movement is present at very low speeds of movement, does not depend on imposed speed, and does not exhibit a speed or angle threshold; 2) simultaneous co-contraction of agonists and antagonists may occur, and this is reflected in an immediate resistance to a reversal of the direction of movement about a joint; 3) the limb does not tend to return toward a particular fixed posture or extreme joint angle; and 4) voluntary activity in distant muscle groups does not lead to involuntary movements about the rigid joints, although rigidity may worsen.Conclusion. We have provided a set of definitions for the purpose of identifying different components of childhood hypertonia. We encourage the development of clinical rating scales that are based on these definitions, and we encourage research to relate the degree of hypertonia to the degree of functional ability, change over time, and societal participation in children with motor disorders. Pediatrics 2003;111:e89 -e97. URL: http://www. pediatrics.org/cgi/content/full/111/1/e89; spasticity, dystonia, rigidity, movement disorders, hypertonia, pediatric, childhood.ABBREVIATION. CP, cerebral palsy.

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“…Spasticity in ankle plantarflexor and knee hamstring muscles was measured with the six-point modified Ashworth scale. 11,12 This test has limited reliability in people with SCI (mean k ¼ 0.37) 12 but is widely used as a clinical test of spasticity in the community setting. 13 At the completion of the trial, participants were asked to rate perceived Global Impression of Change in both the treated and untreated ankle using a 15-point Likert scale where À7 indicates 'very great deal worse', 0 indicates 'no change' and þ 7 indicates 'very great deal better'.…”

Section: Measurementmentioning

confidence: 99%

Effects of 6 months of regular passive movements on ankle joint mobility in people with spinal cord injury: a randomized controlled trial

et al. 2008

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Study design: Assessor-blinded within-subject randomized controlled trial. Objective: To determine the effects of 6 months of regular passive movements on ankle joint mobility in people with spinal cord injury. Setting: Community, Australia. Methods: A total of 20 people with tetraplegia living in the community had one ankle randomized to a control group and the other to an experimental group. Carers administered passive movements to participants' experimental ankles for 10 min, 10 times a week for 6 months. The control ankles were left untreated. The primary outcome was passive ankle dorsiflexion range of motion. Results: Adherence was high (mean adherence rate of 96%). Ankle dorsiflexion range of motion decreased by a mean (s.d.) of 21 (4) in control ankles and increased by 21 (4) in experimental ankles. The mean (95% confidence interval, CI) effect on ankle dorsiflexion range of motion was 41 (95% CI, 2-61). Conclusion: Regular passive movements have small effects on ankle joint mobility. It is unclear if these effects are clinically worthwhile.

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Reliability of the tone assessment scale and the modified ashworth scale as clinical tools for assessing poststroke spasticity

Cited by 349 publications

References 10 publications

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

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

Classification and Definition of Disorders Causing Hypertonia in Childhood

Effects of 6 months of regular passive movements on ankle joint mobility in people with spinal cord injury: a randomized controlled trial

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