Evaluation of Spasticity in Children With Cerebral Palsy Using Ashworth and Tardieu Scales Compared With Laboratory Measures

Abstract

The content validity of the Tardieu Scale and the Ashworth Scale was assessed in 27 independently ambulant children with cerebral palsy (gender: 17 males, 10 females; age: 5-9 years; Gross Motor Function Classification: level I and II). Ashworth and Tardieu Scale scores and laboratory measures of spasticity and contracture were collected from the plantarflexor muscles by 2 examiners who were blinded to the results. The Tardieu Scale was more effective than the Ashworth Scale in identifying the presence of spasticity (88.9%, kappa = 0.73; P = .000), the presence of contracture (77.8%, kappa = 0.503; P = .008) and the severity of contracture (r = 0.49; P = .009). However, neither scale was able to identify the severity of spasticity. The Tardieu Scale can provide useful information in children with cerebral palsy because it differentiates spasticity from contracture. However, a more comprehensive clinical method of testing neural and non-neural contributions to impairments and function is needed.

Effectiveness of Multilevel Botulinum Toxin A Injection with Integrated Treatment Program on Spasticity Reduction in Non-Ambulatory Young Children with Cerebral Palsy

“…Despite its widespread clinical use, the reliability of this scale has been questioned in some studies [18]. MTS is another clinical scale used to assess spasticity; it is not as common as MAS but has been proposed as a more effective method in assessing spasticity [18, 19]. In the present study, based on MTS measurements, spasticity of the gastrocnemius and hamstrings muscles showed significant improvement at the 1st month and this effect continued at 3 months after the BTX-A injection.…”

Impaired gait function in adults with cerebral palsy is associated with reduced rapid force generation and increased passive stiffness

“…The value of studies on the functional significance of spasticity in which this distinction has not been made is therefore unclear. This is especially the case of studies in which 'spasticity' has been determined by clinical evaluation and scored by either the Ashworth or Tardieu scales (Sehgal et al, 1998, Biering-Sorensen et al, 2006, Haugh et al, 2006, Mutlu et al, 2008, Alhusaini et al, 2010, Fleuren et al, 2010, Ansari et al, 2013. As shown by several recent studies, the clinical determination of spasticity often cannot be verified when the patient is subsequently tested by objective biomechanical and electrophysiological techniques (Lorentzen et al, 2010, Willerslev-Olsen et al, 2013.…”

Assessment and Treatment of Spasticity in Children with Cerebral Palsy

“…All scales used for clinical assessment of spasticity could be categorized into three main groups (7) The most commonly used test in clinical practice is the MAS (8). The test is based on the assessment of resistance to passive strech of muscle group at one nonspecified velocity.…”