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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
Author(s) -
Mishra Chittaranjan,
Ganesh G. Shankar
Publication year - 2014
Publication title -
physiotherapy research international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.509
H-Index - 49
eISSN - 1471-2865
pISSN - 1358-2267
DOI - 10.1002/pri.1588
Subject(s) - spasticity , modified ashworth scale , spinal cord injury , physical medicine and rehabilitation , medicine , muscle tone , physical therapy , inter rater reliability , intra rater reliability , stroke (engine) , clonus , plantar flexion , rating scale , spinal cord , psychology , ankle , surgery , developmental psychology , mechanical engineering , psychiatry , epilepsy , engineering , confidence interval
Spasticity occurs in disorders of the central nervous system such as stroke, spinal cord injury (SCI), multiple sclerosis and traumatic brain injury. The recently developed clinical measurement for the measurement of spasticity is the Modified Modified Ashworth Scale (MMAS) Purpose of study The purpose of this study is to determine the inter‐rater reliability of the MMAS in the assessment of plantar flexor spasticity in patients with SCI. Methodology Thirty‐eight subjects (32 males and six females, mean age 31.9 + 12.6 years) were recruited for the study. Excluded from the study were patients with contracture in the lower limb and where passive movements were contraindicated. Procedure Each patient was assessed by two raters in a single session. After the performance of the procedure by the first assessor and rating of the patient's muscle tone with the MMAS, the same procedure was repeated by the second assessor after 1 hour. The evaluation was carried out in side‐lying position. The extent of agreement was analysed by non‐weighted Cohen kappa. Results The agreement between the raters was good (soleus – ĸ: 0.75, SE = 0 .084, p < 0.0001, gastrocnemius – ĸ:0.70, SE = 0.105, p < 0.0001). Conclusion The MMAS has good inter‐rater reliability in the assessment of plantar flexor muscle spasticity in patients with SCI. Copyright © 2014 John Wiley & Sons, Ltd.