Inter-Rater Reliability of Modified Modified Ashworth Scale in the Assessment of Plantar Flexor Muscle Spasticity in Patients with Spinal Cord Injury

Mishra, Chittaranjan; Ganesh, G. Shankar

doi:10.1002/pri.1588

Cited by 18 publications

(16 citation statements)

References 35 publications

(52 reference statements)

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“…Limited ROM occurs not only in patients who have undergone total joint arthroplasty, but also in patients with various conditions including rheumatoid arthritis 28 and spinal cord injury. 29 Rheumatoid arthritis patients often have limited ROM of the hip and knee joints, which can affect their ability to walk, use the toilet, go up/down stairs, get in/out of a bathtub, put on and take off shoes, and clip their toenails. 28 Spinal cord injury patients usually have contractures of at least one joint at 1 year after injury.…”

Section: Discussionmentioning

confidence: 99%

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Hip, knee, and ankle kinematics during activities of daily living: a cross-sectional study

Hyodo

Masuda

Aizawa

et al. 2017

Brazilian Journal of Physical Therapy

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HighlightsSeveral ADLs in healthy individuals had larger joint angles than walking, climbing stairs, and standing up.Large joint angles in healthy individuals occurred at the hip and knee joints during trunk rotation, during crouching, and getting out of the bath.Adduction and internal rotation occurred simultaneously in few healthy individuals during maximum flexion of the hip in the measured tasks.

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Section: Discussionmentioning

confidence: 99%

“…The contracture rate is 32% for the hip, 11% for the knee, and 40% for the ankle. 29 Limited ROM occurs in many conditions, and the joints and motions affected vary among these conditions. Studies investigating the influence of limited ROM on various activities require a large amount of ROM data during these activities.…”

Section: Discussionmentioning

confidence: 99%

Hip, knee, and ankle kinematics during activities of daily living: a cross-sectional study

Hyodo

Masuda

Aizawa

et al. 2017

Brazilian Journal of Physical Therapy

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“…The three muscles in the deep posterior compartment of the leg maintain plantar flexion of the foot and ankle varus. Their spasticity results in spastic equinovarus (Mishra and Ganesh, 2014). The incidence of this clinical phenomenon can be up to 15-18% (Wren et al 2005;Bollens et al, 2013).…”

Section: Discussionmentioning

confidence: 99%

Localization of nerve entry points as targets to block spasticity of the deep posterior compartment muscles of the leg

Zhuo

Zhang

et al. 2017

Clinical Anatomy

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To identify the optimal body surface puncture locations and the depths of nerve entry points (NEPs) in the deep posterior compartment muscles of the leg, 60 lower limbs of thirty adult cadavers were dissected in prone position. A curved line on the skin surface joining the lateral to the medial epicondyles of the femur was taken as a horizontal reference line (H). Another curved line joining the lateral epicondyle of the femur to the lateral malleolus was designated the longitudinal reference line (L). Following dissection, the NEPs were labeled with barium sulfate and then subjected to spiral computed tomography scanning. The projection point of the NEP on the posterior skin surface of the leg was designated P, and the projection in the opposite direction across the transverse plane was designated P'. The intersections of P on H and L were identified as P and P , and their positions and the depth of the NEP on PP' were measured using the Syngo system and expressed as percentages of H, L, and PP'. The P points of the tibial posterior, flexor hallucis longus and flexor digitorum longus muscles were located at 38.10, 46.20, and 55.21% of H, respectively. The P points were located at 25.35, 41.30, and 45.39% of L, respectively. The depths of the NEPs were 49.11, 54.64, and 55.95% of PP', respectively. The accurate location of these NEPs should improve the efficacy and efficiency of chemical neurolysis for treating spasticity of the deep posterior compartment muscles of the leg. Clin. Anat. 30:855-860, 2017. © 2017 Wiley Periodicals, Inc.

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“…13 These are helpful biomechanical outcome measures with good inter-rater reliability. 14,15 Yet, improvement in biomechanical outcome might not be 69 Botox injection for spasticity directly translated into patients' functioning outcome and well-being, which are better represented by the GAS. 16 The latter measures whether and how a patient's individually identified goals are achieved with both patient-rated importance and team-rated difficulty balanced, and thus serves as an effective measure of therapeutic efficacy and subjective wellbeing.…”

Section: Discussionmentioning

confidence: 99%

Botulinum toxin injection and rehabilitation for neurosurgical patients with spasticity

et al. 2016

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Aim: Spasticity gives rise to impairment in motor functions and activities of daily living. Botulinum toxin (BTX) can be injected to temporarily paralyze the affected muscles, which provides a window of opportunity for rehabilitation. We present our 2.5-year experience with BTX injection and a patient-specific rehabilitation program provided by a multidisciplinary team, which consists of neurosurgeons, nurses, physiotherapists, occupational therapists and prosthetic orthotists. Patients and Methods: This is a retrospective study of prospectively collected data in a local hospital including 22 patients suffering from spasticity. Outcome measures include goal attainment, caregiver burden and biomechanical assessment by Modified Ashworth Scale and Modified Tardieu Scale (MTS). Results: OnabotulinumtoxinA injection together with rehabilitation facilitates the attainment of patientcentred physical goals in daily activities. It reduces caregiver burden. Spasticity is reduced particularly for finger and wrist flexors as well as hip adductors. Responses of ankle plantarflexors are less satisfactory which may be due to inadequate dosages. Initial improvement in the R2 component of the MTS for ankle plantarflexors and hip adductors may be attributable to the application of ankle-foot orthosis and abduction pillow. Conclusions: Multidisciplinary management for spasticity is feasible within our healthcare setting and our promising findings indicate its wider adoption in this locality.

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Inter-Rater Reliability of Modified Modified Ashworth Scale in the Assessment of Plantar Flexor Muscle Spasticity in Patients with Spinal Cord Injury

Abstract: The MMAS has good inter-rater reliability in the assessment of plantar flexor muscle spasticity in patients with SCI.

Cited by 18 publications

References 35 publications

Hip, knee, and ankle kinematics during activities of daily living: a cross-sectional study

Hip, knee, and ankle kinematics during activities of daily living: a cross-sectional study

Localization of nerve entry points as targets to block spasticity of the deep posterior compartment muscles of the leg

Botulinum toxin injection and rehabilitation for neurosurgical patients with spasticity

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