Reliability of clinicalspasticity measurements in patients with spinal cord injury in cervical region.
Journal Title: Ortopedia Traumatologia Rehabilitacja - Year 2007, Vol 9, Issue 5
Abstract
The Modified Ashworth Scale (MAS) is the most popular clinical measure of spasticity. Other clinical signs of spasticity include hyperactive tendon reflexes, myoclonus and Babinski sign. PURPOSE: To assess reliability of the MAS with myoclonic and tendon reflex examination (MTR) in patients with spinal cord injury (SCI). MATERIAL: 30 patients (16 with complete and 14 with incomplete neural deficite) who sustained cervical SCI 4-66 months prior to the study. Mean age 33,9 years (SD=14,7). METHODS: 6 idepenedent observers rated MAS and MTR in each patient. RESULTS: Poor interrater reliability of MAS (ICC=0,56) and good reliability of MTR (ICC=0,81) were demonstarted. Satisfactory to good co-relation exists between averaged MAS rates (Pearson co-efficiet 0,67-0,9). MAS reliability was lower in lower limbs and when joint contractures are present. Significantly (p<0,01) lower MAS repeatability was noted in subjects younger than 30. Thewre is a positive dependence between functional abilities and MAS repeatability. Generalized muscle tone, sex, time elapsing from injury do not influence MAS reliability. CONCLUSIONS: However MAS is unreliable in patients with SCI, it may be helpful in establishing of generalized muscular tone. MAS repeatability is lower in younger patients. MAS is inappropriate tool in cases with joint contratures. MTR are more stable signs than muscle tone in SCI patients. Examination of tendon reflexes, myoclonus and Babinski sign is reliable in SCI patients.
Authors and Affiliations
Piotr Tederko , Marek Krasuski , Julita Czech , Agnieszka Dargiel , Iwona Garwacka-Jodzis , Anna Wojciechowska
Keywords
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