scholarly journals Reliability of Measurements Obtained With the Modified Ashworth Scale in the Lower Extremities of People With Stroke

2002 ◽  
Vol 82 (1) ◽  
pp. 25-34 ◽  
Author(s):  
Marjan Blackburn ◽  
Paulette van Vliet ◽  
Simon P Mockett
Keyword(s):  
Lower Limb ◽  
Interrater Reliability ◽  
Rating Scale ◽  
Muscle Tone ◽  
Motor Disorder ◽  
Intrarater Reliability ◽  
Point Rating Scale ◽  
Modified Ashworth Scale ◽  
Ashworth Scale ◽  
Quadriceps Femoris Muscles

Abstract Background and Purpose. Abnormal muscle tone is a common motor disorder following stroke, which may require rehabilitation. The Modified Ashworth Scale is a 6-point rating scale that is used to measure muscle tone. The interrater and intrarater reliability of measurements obtained with the scale remain equivocal. The purpose of this study was to investigate the reliability of measurements obtained with the scale in the lower limb of patients with stroke. Subjects. Twenty patients were tested 2 weeks after their stroke, and 12 patients were tested 12 weeks after their stroke. Methods. Gastrocnemius, soleus, and quadriceps femoris muscles on the hemiplegic side were tested. Results. Interrater reliability for 2 raters was poor, with a Kendall tau-b correlation for the combined muscle group of .062 (P=.461). For intrarater reliability, the Kendall tau-b correlation was .567 (P<.001). The agreement within one rater occurred mostly on the grade of 0. Discussion and Conclusion. The Modified Ashworth Scale yielded reliable measurements in the lower limb for a single examiner, and agreement was best on the grade of 0. The reliability between examiners was not good, which may bring into question the validity of measurements obtained with the scale.

Interrater reliability of the Modified Modified Ashworth Scale (MMAS) for patients with wrist flexor muscle spasticity

2008 ◽  
Vol 24 (5) ◽  
pp. 372-379 ◽  
Author(s):  
Soofia Naghdi ◽  
Noureddin Nakhostin Ansari ◽  
Somayye Azarnia ◽  
Anoushiravan Kazemnejad
Keyword(s):  
Interrater Reliability ◽  
Flexor Muscle ◽  
Muscle Spasticity ◽  
Wrist Flexor ◽  
Modified Ashworth Scale ◽  
Ashworth Scale

Speech-Language Pathologists' Ratings of Speech Accuracy in Children With Speech Sound Disorders

2021 ◽  
pp. 1-12
Author(s):  
Linye Jing ◽  
Maria I. Grigos
Keyword(s):  
Interrater Reliability ◽  
Rating Scales ◽  
Rating Scale ◽  
Speech Sound ◽  
Future Research ◽  
Training Procedure ◽  
Speech Sound Disorders ◽  
Speech Language Pathologists ◽  
Point Rating Scale ◽  
Whole Word

Purpose: Forming accurate and consistent speech judgments can be challenging when working with children with speech sound disorders who produce a large number and varied types of error patterns. Rating scales offer a systematic approach to assessing the whole word rather than individual sounds. Thus, these scales can be an efficient way for speech-language pathologists (SLPs) to monitor treatment progress. This study evaluated the interrater reliability of an existing 3-point rating scale using a large group of SLPs as raters. Method: Utilizing an online platform, 30 SLPs completed a brief training and then rated single words produced by children with typical speech patterns and children with speech sound disorders. Words were closely balanced across the three rating categories of the scale. The interrater reliability of the SLPs ratings to a consensus judgment was examined. Results: The majority of SLPs (87%) reached substantial interrater reliability to a consensus judgment using the 3-point rating scale. Correct productions had the highest interrater reliability. Productions with extensive errors had higher agreement than those with minor errors. Certain error types, such as vowel distortions, were especially challenging for SLPs to judge. Conclusions: This study demonstrated substantial interrater reliability to a consensus judgment among a large majority of 30 SLPs using a 3-point rating. The clinical implications of the findings are discussed along with proposed modifications to the training procedure to guide future research.

Inter- and intrarater reliability of the Modified Modified Ashworth Scale in patients with knee extensor poststroke spasticity

2008 ◽  
Vol 24 (3) ◽  
pp. 205-213 ◽  
Author(s):  
Noureddin Nakhostin Ansari ◽  
Soofia Naghdi ◽  
Parastoo Younesian ◽  
Mohammad Shayeghan
Keyword(s):  
Knee Extensor ◽  
Intrarater Reliability ◽  
Modified Ashworth Scale ◽  
Ashworth Scale

scholarly journals Botulinum Toxin Type A and Physiotherapy in Spasticity of the Lower Limbs Due to Amyotrophic Lateral Sclerosis

Toxins ◽  
2019 ◽  
Vol 11 (7) ◽  
pp. 381 ◽  
Author(s):  
Riccardo Marvulli ◽  
Marisa Megna ◽  
Aurora Citraro ◽  
Ester Vacca ◽  
Marina Napolitano ◽  
...  
Keyword(s):  
Amyotrophic Lateral Sclerosis ◽  
Rating Scale ◽  
Botulinum Toxin Type A ◽  
Type A ◽  
Botulinum Toxin Type ◽  
Lower Limbs ◽  
Number Of Patients ◽  
Modified Ashworth Scale ◽  
Ashworth Scale ◽  
Lateral Sclerosis

Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease (unknown pathogenesis) of the central nervous system that causes death within 1–5 years. Clinically, flabby paralysis, areflexia, muscular atrophy, and muscle fasciculations, signs of II motor neuron damage, appear. Sometimes, clinical manifestations of damage of the I motor neuron come out in lower limbs; spastic paralysis, iperflexia, and clonus emerge, and they impair deambulation and management of activities of daily living, such as personal hygiene or dressing. Thus, the first therapeutic approach in these patients involves antispasmodic drugs orally followed by botulinum toxin type A injection (BTX-A). In this study, we study the efficacy of BTX-A and physiotherapy in lower limb spasticity due to ALS and no response to treatment with oral antispastic drugs. We evaluated 15 patients (10 male and five female), with a mean age of 48.06 ± 5.2 with spasticity of adductor magnus (AM), at baseline (T0, before BTX-A treatment) and in the following three follow-up visits (T1 30 days, T2 60 days, and T3 90 days after infiltration). We evaluated myometric measure of muscle tone, the Modified Ashworth Scale of AM, Barthel Index, Adductor Tone Rating Scale, and Hygiene Score. The study was conducted between November 2018 and April 2019. We treated AM with incobotulinum toxin type A (Xeomin®, Merz). Spasticity (myometric measurement, Adductor Tone Rating Scale, and Modified Ashworth Scale) and clinical (Barthel Index and Hygiene Score) improvements were obtained for 90 days after injection (p < 0.05). Our study shows the possibility of using BTX-A in the treatment of spasticity in patients with ALS and no response to oral antispastic drugs, with no side effects. The limitation of the study is the small number of patients and the limited time of observation; therefore, it is important to increase both the number of patients and the observation time in future studies.

scholarly journals Interrater Reliability of the Berg Balance Scale When Used by Clinicians of Various Experience Levels to Assess People With Lower Limb Amputations

2014 ◽  
Vol 94 (3) ◽  
pp. 371-378 ◽  
Author(s):  
Christopher K. Wong
Keyword(s):  
Lower Limb ◽  
Interrater Reliability ◽  
Clinical Training ◽  
Intraclass Correlation ◽  
Berg Balance Scale ◽  
Intrarater Reliability ◽  
Rater Reliability ◽  
Study Objective ◽  
Balance Scale ◽  
Scale Scores

Background People with lower limb amputations frequently have impaired balance ability. The Berg Balance Scale (BBS) has excellent psychometric properties for people with neurologic disorders and elderly people dwelling in the community. A Rasch analysis demonstrated the validity of the BBS for people with lower limb amputations of all ability strata, but rater reliability has not been tested. Objective The study objective was to determine the interrater reliability and intrarater reliability of BBS scores and the differences in scores assigned by testers with various levels of experience when assessing people with lower limb amputations. Design This reliability study of video-recorded single-session BBS assessments had a cross-sectional design. Methods From a larger study of people with lower limb amputations, 5 consecutively recruited participants using prostheses were video recorded during an in-person BBS assessment. Sixteen testers independently rated the video-recorded assessments. Testers were 3 physical therapists, 1 occupational therapist, 3 third-year and 4 second-year doctor of physical therapy (DPT) students, and 5 first-year DPT students without clinical training. Rater reliability was calculated using intraclass correlation coefficients (ICC [2,k]). Differences in scores assigned by testers with various levels of experience were determined by use of an analysis of variance with Tukey post hoc tests. Results The average age of the participants was 53.0 years (SD=15.7). Amputations had occurred at the ankle disarticulation, transtibial, and transfemoral levels because of vascular, trauma, and medical etiologies an average of 8.2 years earlier (SD=7.9). Berg Balance Scale scores spanned all ability strata. Interrater reliability (ICC [2,k]=.99) and intrarater reliability of scores determined in person and through video-recorded assessments by the same testers (ICC [2,k]=.99) were excellent. For participants with the lowest levels of ability, licensed professionals assigned lower scores than did DPT students without clinical training. Limitations Intrarater reliability calculations were based on 2 testers. Conclusions Berg Balance Scale scores assigned to people using prostheses by testers with various levels of clinical experience had excellent interrater reliability and intrarater reliability.

scholarly journals The Effect of Kinesio Taping on Spasticity: A Randomized, Controlled, Double-Blind Pilot Study in Para-Swimmers

2020 ◽  
pp. 1-8
Author(s):  
Luca Puce ◽  
Ilaria Pallecchi ◽  
Lucio Marinelli ◽  
Maria May ◽  
Laura Mori ◽  
...  
Keyword(s):  
Stretch Reflex ◽  
Research Council ◽  
Rating Scale ◽  
Medical Research Council ◽  
Swimming Performance ◽  
Knee Extensor ◽  
Numeric Rating Scale ◽  
Modified Ashworth Scale ◽  
Ashworth Scale ◽  
Numeric Rating

Context: Kinesio Taping (KT) produces several clinical effects, including pain relief, edema absorption, and improved muscle performance. When applied in the insertion to origin mode, it is claimed to inhibit excessive muscle contractions. Objective: Investigate whether KT applied in the insertion to origin mode could reduce the exaggerated reflex contraction of spastic muscles. Design: Randomized crossover trial, with a restricted block randomization. Setting: Clinical laboratory and swimming pool. Patients: Seven para-swimmers. Intervention: KT, applied in inhibitory mode, to investigate its effect on knee extensor spasticity. Main Outcome Measures: Primary outcome is stretch reflex, as compared with clinical assessment of spasticity by Modified Ashworth Scale and self-perceived spasticity by numeric rating scale. Secondary outcomes were Medical Research Council for strength of knee extensor muscles and chronometric swimming performance in 100-m freestyle. Results: KT significantly decreased the amplitude of stretch reflex (P < .001), whereas the placebo treatment produced no significant effects. Scores of Medical Research Council for strength and Modified Ashworth Scale did not change after KT, whereas numeric rating scale scores for spasticity significantly decreased (P = .001). The swimming performance was significantly improved after KT treatment as compared with baseline (P < .01). Conclusions: This exploratory study performed on para-athletes suggests that KT could reduce spasticity. This outcome has 3-fold implications for clinical, rehabilitation, and sport methods.

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