Inter- and intrarater reliability of the Ashworth Scale and the Disability Assessment Scale in patients with upper-limb poststroke spasticity☆,☆☆,★,★★,♢
Section snippets
Participants
Ten patients with upper-limb spasticity were recruited for this single-center trial. Patients were required to be at least 21 years of age; to have a documented history of stroke that resulted in spasticity of the elbow, wrist, finger, and/or thumb flexors in at least 1 limb; and to have some degree of impairment pertaining to hygiene, dressing, limb position, or pain.
The protocol excluded patients who had experienced a stroke within 6 months of study enrollment, had a cast on the affected
Patient characteristics
Ten patients were screened, entered the study, and completed both evaluations. One patient was reported as having a major protocol deviation (ie, he had taken a dose of antispasticity medication on the morning of the study day). Data for this patient were not included in the analysis.
Demographic characteristics of the study population are provided in table 1.Age (y) Mean ± SD 59.9±16.17 Median 69 Range 37–81 Gender Men 5 (55.6%) Women 4 (44.4%) Race White 6 (66.7%)
Discussion
Quantification of muscle tone and associated impairment remains a clinical challenge due to the intricate relationship of this feature with other complications of the upper motoneuron syndrome (eg, muscle contracture, spastic dystonia).10 Over the past several years, numerous methods have been developed to provide information about the resistance of the spastic limb to passive joint movement.3, 11 Although some of these methods have proven useful for assessing functional outcomes of patients
Conclusion
This study showed that the Ashworth Scale and the DAS have good intra- and interrater reliability when used by trained medical professionals to rate excessive tone and functional impairment in patients with upper-limb spasticity after stroke. These scales can be used readily in the clinical setting.
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Cited by (205)
The Combined Effect of Robot-assisted Therapy and Activities of Daily Living Training on Upper Limb Recovery in Persons With Subacute Stroke: A Randomized Controlled Trial
2024, Archives of Physical Medicine and RehabilitationReal-World Adherence to OnabotulinumtoxinA Treatment for Spasticity: Insights From the ASPIRE Study
2021, Archives of Physical Medicine and RehabilitationCitation Excerpt :However, it should be noted that severe spasticity can also interfere with, or prevent the use of, assistive devices. Spasticity-related pain in the upper limb, as assessed by DAS,12 was also associated with nonadherence in both models and could be due to a multifactorial or central driver.23,24 Notwithstanding, several trials have demonstrated the benefits of onabotulinumtoxinA for the management of spasticity-related pain,25-30 suggesting that pain relief may be an appropriate secondary goal of onabotulinumtoxinA treatment.
Effect of a Novel Perturbation-Based Pinch Task Training on Sensorimotor Performance of Upper Extremity for Patients With Chronic Stroke: A Pilot Randomized Controlled Trial
2021, Archives of Physical Medicine and RehabilitationCitation Excerpt :The score is the number of blocks carried from one box to another in 1 minute. Modified Ashworth Scale (MAS): The MAS is a scale that has been shown to have good intra- and interrater reliability for grading the resistance encountered during passive soft-tissue stretching in patients with upper-limb poststroke spasticity.25 It was recorded using a 6-point scale.
A network meta-analysis of the effect of rehabilitation robots on hand motor function after stroke
2024, Chinese Journal of Rehabilitation Medicine
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Supported by Allergan Inc (grant no. 45-843-14).
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No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.
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Reprint requests to Allison Brashear, MD, Indiana University Medical Ctr, 550 University Blvd, Rm 6620, Indianapolis, IN 46202-5167, e-mail: [email protected].
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Supplier
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a. StatXact associated with SAS; Cytel Software Corp, 675 Massachusetts Ave, Cambridge, MA 02139.