Journal of Rehabilitation Research & Development (JRRD)

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Volume 48 Number 1, 2011
   Pages 83 — 88

Abstract —  Measurement of lower-limb muscle spasticity: Intrarater reliability of Modified Modified Ashworth Scale

Nastaran Ghotbi, PhD, PT;1 Noureddin Nakhostin Ansari, PhD, PT;1* Soofia Naghdi, PhD, PT;1 Scott Hasson, EdD, PT2

1Faculty of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran; 2Physical Therapy Department, Angelo State University, San Angelo, TX

Abstract — The Modified Modified Ashworth Scale (MMAS) is a clinical instrument for measuring spasticity. Few studies have been performed on the reliability of the MMAS. The aim of the present study was to investigate the intrarater reliability of the MMAS for the assessment of spasticity in the lower limb. We conducted a test-retest study on spasticity in the hip adductors, knee extensors, and ankle plantar flexors. Each patient was measured by a hospital-based clinical physiotherapist. Twenty-three patients with stroke or multiple sclerosis (fourteen women, nine men) and a mean +/- standard deviation age of 37.3 +/- 14.1 years participated. The weighted kappa was moderate for the hip adductors (weighted kappa = 0.45, standard error [SE] = 0.16, p = 0.007), good for the knee extensors (weighted kappa = 0.62, SE = 0.12, p < 0.001), and very good for the ankle plantar flexors (weighted kappa = 0.85, SE = 0.05, p < 0.001). The kappa value for overall agreement was very good (weighted kappa = 0.87, SE = 0.03, p < 0.001). The reliability for the ankle plantar flexors was significantly higher than that for the hip adductors. The intrarater reliability of the MMAS in patients with lower-limb muscle spasticity was very good, and it can be used as a measure of spasticity over time.

Key words: ankle plantar flexors, hip adductors, intrarater, knee extensors, lower limb, MMAS, Modified Modified Ashworth Scale, muscle spasticity, rehabilitation, reliability.


View HTML  ¦  View PDF  ¦  Contents Vol. 48, No. 1

Ghotbi N, Nakhostin Ansari N, Naghdi S, Hasson S.
Measurement of lower-limb muscle spasticity: Intrarater reliability of Modified Modified Ashworth Scale.
J Rehabil Res Dev. 2011;48(1):83-88.
DOI:10.1682/JRRD.2010.02.0020
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