Tardieu Scale

Original Editor - Shreya Pavaskar
Top Contributors - Shreya Pavaskar, Kim Jackson and Rucha Gadgil

Introduction[edit | edit source]

The Tardieu Scale and the Modified Tardieu Scale are used clinically to measure spasticity in patients with neurological conditions.

The Tardieu Scale was developed by Tardieu et al in 1954. Held and Pierrot-Deseilligny modified it in 1969, and it was further modified in 1999 by Boyd and Graham[1]

Purpose[edit | edit source]

The purpose of these scales is to quantify spasticity by assessing the muscle's response to different stretch velocities and by determining the spasticity angle .

Tardieu scale has been utilized in the following populations: stroke, spinal cord injury, multiple sclerosis, cerebral palsy, traumatic brain injury, pediatric hypertonia and central nervous system lesions

Technique[edit | edit source]

A standard goniometer will be utilized to measure R2 and R1. The patient will be in testing position according to the muscle to be tested. The stretching velocity of V1 and V3 will be applied to measure R2 and R1, respectively. The quality of muscle reaction will be graded at the stretching velocity of V3 as well. The difference between R2 and R1 will be the measure of the dynamic component of spasticity.


Scoring[edit | edit source]

The scoring is done as follows[3] -

Quality of Muscle Reaction

0 No resistance throughout passive movement
1 Slight resistance throughout,with no clear catch at a precise angle
2 Clear catch at a precise angle followed by release
3 Fatiguable Clonus (< 10 secs) occurring at a precise angleFatiguable Clonus (< 10 secs) occurring at a precise angle
4 Unfatiguable Clonus (> 10 secs) occurring at a precise angle
5 Joint immobile

Velocity to Stretch

V1 As slow as possible
V2 Speed of the limb segment falling (with gravitational pull)
V3 At a fast rate (>gravitational pull)

Spasticity Angle

R1 Angle of catch seen at Velocity V2 or V3
R2 Full range of motion achieved when muscle is at rest and tested at V1 velocity

Evidence[edit | edit source]

Reliability - There are no studies conducted that examined the internal consistency of the Modified Tardieu Scale in clients with stroke. There is excellent test-retest reliability with inertial sensors and goniometry.[4] Two studies examined the intra-rater reliability.[5] Repeated Modified Tardieu Scale measurements of spasticity are best based on R1 measurements rather than spasticity angle or qualitative ratings of spasticity.[6]

Validity - No studies have examined the content.

Resources[edit | edit source]

Modified Ashworth Scale


References[edit | edit source]

  1. Abolhasani H, Ansari NN, Naghdi S, Mansouri K, Ghotbi N, Hasson S. Comparing the validity of the Modified Modified Ashworth Scale (MMAS) and the Modified Tardieu Scale (MTS) in the assessment of wrist flexor spasticity in patients with stroke: protocol for a neurophysiological study. BMJ open. 2012 Jan 1;2(6).
  2. Alison Finan. Tardieu Spasticity Scale. Available from: http://www.youtube.com/watch?v=b_ss3TWwfiw[last accessed 14/4/2021]
  3. Morris S. Ashworth and Tardieu Scales: Their clinical relevance for measuring spasticity in adult and paediatric neurological populations. Physical Therapy Reviews. 2002 Mar 1;7(1):53-62.
  4. Paulis WD, Horemans HL, Brouwer BS, Stam HJ. Excellent test–retest and inter-rater reliability for Tardieu Scale measurements with inertial sensors in elbow flexors of stroke patients. Gait & posture. 2011 Feb 1;33(2):185-9.
  5. Singh P, Joshua AM, Ganeshan S, Suresh S. Intra-rater reliability of the modified Tardieu scale to quantify spasticity in elbow flexors and ankle plantar flexors in adult stroke subjects. Annals of Indian Academy of Neurology. 2011 Jan;14(1):23.
  6. Ben-Shabat E, Palit M, Fini NA, Brooks CT, Winter A, Holland AE. Intra-and interrater reliability of the Modified Tardieu Scale for the assessment of lower limb spasticity in adults with neurologic injuries. Archives of physical medicine and rehabilitation. 2013 Dec 1;94(12):2494-501.