Age and Ageing, Vol 29, 223-228, Copyright © 2000 by British Geriatrics Society
J Gregson, M Leathley, A Moore, T Smith, A Sharma and C Watkins
Objectives. To establish the reliability of the
modified Ashworth scale for measuring muscle tone in a range of muscle
groups (elbow, wrist, knee and ankle; flexors and extensors) and of the
Medical Research Council scale for measuring muscle power in the same
muscle groups and their direct antagonists.Design. A
cross-sectional study involving repeated measures by two raters. We
estimated reliability using the k statistic with
quadratic weights (Kw).Setting. An acute stroke ward,
a stroke rehabilitation unit and a continuing care
facility.Subjects. People admitted to hospital with an
acute stroke - 35 patients, median age 73 (interquartile range 65-80), 20
men and 15 women.Results. Inter- and intra-rater
agreement for the measurement of power was good to very good for all tested
muscle groups (Kw=0.84-0.96, Kw=0.70-0.96). Inter- and intra-rater
agreement for the measurement of tone in the elbow, wrist and knee flexors
was good to very good (Kw=0.73-0.96, Kw=0.77-0.94). Inter- and intra-rater
agreement for the measurement of tone in the ankle plantarflexors was
moderate to good (Kw=0.45-0.51, Kw=0.59-0.64).Conclusion.
The Medical Research Council scale was reliable in the tested
muscle groups. The modified Ashworth scale demonstrated reliability in all
tested muscle groups. The modified Ashworth scale demonstrated reliability
in all tested muscle groups except the ankle plantarflexors. If reliable
measurement of tone at the ankle is required for a specific purpose (e.g.
to measure the effect of therapeutic intervention), further work will be
necessary.Keywords: Ashworth scale, measurement,
Medical Research Council scale, muscle power, muscle tone, spasticity,
stroke
ARTICLES
Reliability of measurement of muscle tone and muscle power in stroke patients
Aintree Stroke Unit, Department of Medicine for the Elderly, University Hospital, Aintree, Longmoore Lane, Liverpool L9 7AL, UK; The Walton Centre for Neurology and Neurosurgery, Liverpool, UK; Corresponding author; Fax: (+44) 151 529 3787; E-mail: cwatkins@aintreestar.u-net.com
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