Stop using the Ashworth Scale for the assessment of spasticity

Fleuren, J.F.M.; Voerman, Gerlienke; Erren-Wolters, Catelijne Victorien; Snoek, Govert J.; Rietman, Johan Swanik; Hermens, Hermie; Nene, A.V.

doi:10.1136/jnnp.2009.177071

Cited by 373 publications

(301 citation statements)

References 24 publications

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“…However, the validity of these instruments for measuring either spasticity or muscle tone was beyond the scope of this study. After the start of our study a manuscript was published entitled, ''Stop using the Ashworth Scale for the assessment of spasticity'' (Fleuren et al, 2010). Taking their paper into account, we recommend that the validity of the MAS be examined further in future studies.…”

Section: Discussionmentioning

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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Section: Discussionmentioning

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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“…Clinical assessment of tone is subjective, using manual assessment by rating resistance to passive movement on scales such as the Modified Ashworth Scale (MAS) for stroke (Fleuren et al 2010) and the Unified Parkinson's disease Rating Scale (UPDRS) for PD (Goetz et al 2003).…”

Section: Introductionmentioning

confidence: 99%

Measurement of ageing effects on muscle tone and mechanical properties of rectus femoris and biceps brachii in healthy males and females using a novel hand-held myometric device

Agyapong‐Badu

Warner

Samuel

et al. 2016

Archives of Gerontology and Geriatrics

136

125

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Please cite this article as: Agyapong-Badu, Sandra, Warner, Martin, Samuel, Dinesh, Stokes, Maria, Measurement of ageing effects on muscle tone and mechanical properties of rectus femoris and biceps brachii in healthy males and females using a novel hand-held myometric device.Archives of Gerontology and Geriatrics http://dx.doi.org/10. 1016/j.archger.2015.09.011 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Monitoring changes in muscle properties with ageing in community settings may provide a valuable assessment tool for detecting those at risk of premature decline and sarcopenia.Objective: This study aimed to provide objective data on the effects of ageing and gender on muscle tone and mechanical properties of quadriceps (rectus femoris) and biceps brachii muscles.Methods: In a comparative study of 123 healthy males and females (aged 18-90 years; n=61 aged18-35; n=62 aged 65-90) muscle tone, elasticity and stiffness were measured using the MyotonPRO device.Results: Stiffness was greater and elasticity lower in older adults for BB and RF (p<0.001). Tone was significantly greater in older adults for BB but not for RF when data for males and females were combined (p=0.28). There were no gender differences for BB in either age group. In RF, males had greater stiffness (young males 292 vs females 233 N/m; older males 328 vs females 311 N/m) and tone (young 16.4 vs 13.6 Hz; older 16.7 vs 14.9 Hz).Elasticity in RF was lower in young males than females but did not differ between the older groups (both males and females log decrement 1.6).Conclusions: Stiffness and tone increased with ageing and elasticity decreased. These findings have implications for detecting frailty using a novel biomarker. Age and gender differences are important to consider when assessing effects of pathological conditions on muscle properties in older people.

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“…However, the reliability and validity of these scales has been recently challenged [10][11][12][13][14][15][16]. In an attempt to improve the quality of the Ashworth scales, Ansari et al modified the Bohannon-Smith modified Ashworth scale, titling the new scale the Modified Modified Ashworth Scale (MMAS) [10].…”

Section: Introductionmentioning

confidence: 99%

Measurement of lower-limb muscle spasticity: Intrarater reliability of Modified Modified Ashworth Scale

Ghotbi¹,

Ansari²,

Naghdi³

et al. 2011

JRRD

106

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Abstract-The Modified Modified Ashworth Scale (MMAS) is a clinical instrument for measuring spasticity. Few studies have been performed on the reliability of the MMAS. The aim of the present study was to investigate the intrarater reliability of the MMAS for the assessment of spasticity in the lower limb. We conducted a test-retest study on spasticity in the hip adductors, knee extensors, and ankle plantar flexors. Each patient was measured by a hospital-based clinical physiotherapist. Twenty-three patients with stroke or multiple sclerosis (fourteen women, nine men) and a mean +/-standard deviation age of 37.3 +/-14.1 years participated. The weighted kappa was moderate for the hip adductors (weighted kappa = 0.45, standard error [SE] = 0.16, p = 0.007), good for the knee extensors (weighted kappa = 0.62, SE = 0.12, p < 0.001), and very good for the ankle plantar flexors (weighted kappa = 0.85, SE = 0.05, p < 0.001). The kappa value for overall agreement was very good (weighted kappa = 0.87, SE = 0.03, p < 0.001). The reliability for the ankle plantar flexors was significantly higher than that for the hip adductors. The intrarater reliability of the MMAS in patients with lower-limb muscle spasticity was very good, and it can be used as a measure of spasticity over time.

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Stop using the Ashworth Scale for the assessment of spasticity

Cited by 373 publications

References 24 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

Measurement of ageing effects on muscle tone and mechanical properties of rectus femoris and biceps brachii in healthy males and females using a novel hand-held myometric device

Measurement of lower-limb muscle spasticity: Intrarater reliability of Modified Modified Ashworth Scale

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