Modified Ashworth Scale
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Top Contributors - Habibu Salisu Badamasi and Shreya Pavaskar
Objective[edit | edit source]
Modified Ashworth Scale (MAS) are used to assess spasticity.[1]
Intended Population[edit | edit source]
MAS have been utilized in the following populations: stroke, spinal cord injury, multiple sclerosis, cerebral palsy, traumatic brain injury, pediatric hypertonia, and central nervous system lesions[2]
Method of Use[edit | edit source]
Description
its performed by extending the patients limb first from a position of maximal possible flexion to maximal possible extension ( the point at which the first soft resistance is met). Afterwards,the modified Ashworth scale is assessed while
moving from extension to flexion[3]
scoring
0 No increase in tone
1 slight increase in tone giving a catch when slight increase in muscle tone, manifested by the limb was moved in flexion or extension.
1+ slight increase in muscle tone, manifested by a catch followed by minimal resistance throughout (ROM )
2 more marked increase in tone but more marked increased in muscle tone through most limb easily flexed
3 considerable increase in tone, passive movement difficult
4 limb rigid in flexion or extension
Reference[edit | edit source]
Studies that have investigated the reliability of the modified Ashworth Scale as measures of spasticity[4]
| Reference | Study details | Relevant results |
|---|---|---|
| Bohannon and Smith (1987)13 | Inter-rater reliability of the MAS. Muscles tested: elbow flexors in the impaired arm. Ns = 30 [MS (1), HI (5), CVA (24) ] Na = 2 [physiotherapist] The assessors independently assessed each subject once | 86.7% agreement between assessors (Kendall’s τ = 0.847; p <0.001) Cohen’s κ was calculated as 0.826a |
| Bodin and Morris (1991)48 | Inter-rater reliability of the MAS. Muscle tested: wrist flexors. Ns = 18 [CVA] Na = 2 [physiotherapist] The assessors independently assessed each subject under three different conditions (immediately after positioning, after a 90 s stretch of the flexors and after a 90 s stretch of the extensors). | 76% agreement between assessors (Kendall’s τ of 0.857) Cohen’s κ was calculated as 0.745a |
| Sloan et al. (1992)49 | Inter-rater reliability of the MAS. Muscles tested: elbow flexors and extensors, and knee flexors. Measurements taken bilaterally. Ns = 34 [hemiplegia] Na = 4 [physiotherapist (2), doctor (2) ] The assessors serially assessed each subject und | Spearman’s ρ varied from 0.56 and 0.90 at the elbow and between 0.26 and 0.62 at the knee |
| Allison et al. (1996)50 | Inter- and Intra-rater reliability of the MAS. Muscles tested: ankle plantar flexors. Measurements were taken bilaterally. Day-1 of testing Ns = 30 [HI] Na = 2 [physiotherapist] Both testers assessed all subjects independently. Day-2 of testing Tester 1 assessed Ns = 21 subjects. | Day-1 Inter-rater reliability tester 1 and tester 2: 55% agreement (ρ = 0.727; τ = 0.647; κ = 0.397) Intra-rater reliability of tester 1: 53% agreement (ρ = 0.741; τ = 0.674; κ = 0.694) Intra-rater reliability of tester 2: 48% agreement (ρ = 0.550; τ = 0.478; κ = 0.286) Day-2 Intra-rater reliability of tester 1: 58% agreement (ρ = 0.821; τ = 0.739; κ 0.422) |
Evidence[edit | edit source]
Reliability[edit | edit source]
Validity[edit | edit source]
Responsiveness[edit | edit source]
Miscellaneous[edit | edit source]
Links[edit | edit source]
References[edit | edit source]
- ↑ Charalambous CP. Interrater reliability of a modified Ashworth scale of muscle spasticity. InClassic papers in orthopaedics 2014 (pp. 415-417). Springer, London.
- ↑ 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.
- ↑ Rw B, Smith MB. Interrater reliability of a modified Ashworth scale of muscle spasticity. Phys ther. 1987;67(2):206-7.
- ↑ Ad P, Johnson GR. Price CiM, Curless RH, Barnes MP, Rodgers H. A review of the properties and limitations of the Ashworth and modified Ashworth Scales as measures of spasticity. Clin Rehabil. 1999;13(5):373-83.
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