What's the risk of using the Modified Ashworth Scale (MAS) to assess spasticity at the ankle?

Davies²,

et al. 2014

J Rehabil Res Dev

This article provides a comprehensive review of studies that investigated ankle assessment techniques to better understand those that can be used in the real-time monitoring of rehabilitation progress for implementation in conjunction with robot-assisted therapy. Seventy-six publications published between January 1980 and August 2013 were selected based on eight databases. They were divided into two main categories (16 qualitative and 60 quantitative studies): 13 goniometer studies, 18 dynamometer studies, and 29 studies about innovative techniques. A total of 465 subjects participated in the 29 quantitative studies of innovative measurement techniques that may potentially be integrated in a real-time monitoring device, of which 19 studies included less than 10 participants. Results show that qualitative ankle assessment methods are not suitable for real-time monitoring in robot-assisted therapy, though they are reliable for certain patients, while the quantitative methods show great potential. The majority of quantitative techniques are reliable in measuring ankle kinematics and kinetics but are usually available only for use in the sagittal plane. Limited studies determine kinematics and kinetics in all three planes (sagittal, transverse, and frontal) where motions of the ankle joint and the subtalar joint actually occur.

Section: Resultsmentioning

confidence: 99%

“…Ansari et al found that reliability of the Modified Tardieu Scale in the assessment of poststroke ankle plantar flexor spasticity was not high [46], and Campanini et al demonstrated that the treatment of ankle spasticity for patients with cerebral vascular accident could not rely on the Ashworth score completely [47].…”

Section: Scoring Systemsmentioning

confidence: 99%

Reviewing effectiveness of ankle assessment techniques for use in robot-assisted therapy

Davies²,

et al. 2014

J Rehabil Res Dev

“…Subjective clinical assessments of spasticity include the Tardieu scale, the Ashworth scale [9], and the modified Ashworth scale (MAS) [10]. Although these tests have the advantage of clinical feasibility, the interpretation of the results relies on the operator’s experience and judgement, which may vary substantially between different clinicians and lead to low test reliability.…”

Section: Introductionmentioning

confidence: 99%

Novel application of a Wii remote to measure spasticity with the pendulum test: Proof of concept

et al. 2016

Background The pendulum test is a standard clinical test for quantifying the severity of spasticity. In the test, an electrogoniometer is typically used to measure the knee angular motion. The device is costly and difficult to set up such that the pendulum test is normally time consuming. Objective The goal of this study is to determine whether a Nintendo Wii remote can replace the electrogroniometer for reliable assessment of the angular motion of the knee in the pendulum test. Methods The pendulum test was performed in three control participants and 13 hemiplegic stroke patients using both a Wii remote and an electrogoniometer. The correlation coefficient and the Bland–Altman difference plot were used to compare the results obtained from the two devices. The Wilcoxon signed-rank test was used to compare the difference between hemiplegia-affected and nonaffected sides in the hemiplegic stroke patients. Results There was a fair to strong correlation between measurements from the Wii remote and the electrogoniometer (0.513 < R2 < 0.800). Small but consistent differences between the Wii remote and electrogoniometer were identified from the Bland–Altman difference plot. Within the hemiplegic stroke patients, both devices successfully distinguished the hemiplegia-affected (spastic) side from the nonaffected (nonspastic) side (both with p < .0001*). In addition, the intraclass correlation coefficient, standard error of measurement, and minimum detectable differences were highly consistent for both devices. Conclusion Our findings suggest that the Wii remote may serve as a convenient and cost-efficient tool for the assessment of spasticity.

2016 38th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC)

Pendulum test measure correlates with gait parameters in children with cerebral palsy

Lotfian

Mirbagheri

Kharazi

et al. 2016

Individuals with cerebral palsy (CP) usually suffer from different impairments including gait impairment and spasticity. Spastic hypertonia is a defining feature of spasticity and manifests as a mechanical abnormality. The objective of this study was to determine the relationship between spastic hypertonia and gait impairments in spastic children with CP, addressing an important controversial issue. Spastic hypertonia was quantified using the pendulum test. The gait impairments were evaluated using the motion capture system in a gait laboratory. Our results showed significant correlations among gait parameters; i.e. walking speed, step length, and the pendulum test measures. This indicates that neuromuscular abnormalities are associated with spasticity and may contribute to gait impairments. The clinical implication is that the impaired gait in children with CP may be improved with the treatment of neuromuscular abnormalities.