RELIABILITY OF THE MODIFIED ASHWORTH SCALE IN THE ASSESSMENT OF PLANTAR FLEXOR MUSCLE SPASTICITY IN PATIENTS WITH TRAUMATIC BRAIN INJURY

Although the Modified Ashworth Scale (MAS) is commonly used to assess the severity of muscle spasticity for ankle plantarflexors, its reliab ility has only been established for elbow muscles. Interrater reliabil ity, intrarater reliability and temporal (between-days) reliability we re examined in this study. Also, interrater reliability for use of the scale with plantarflexors was compared with reported results from the measurement of elbow flexors. Thirty adult volunteers with traumatic brain injuries participated. There were 20 men and 10 women; the mean age was 28.3 years (SD = 10.8). Two physical therapists used the MAS t o score the subjects independently Measurements were repeated to yield multiple scores for intrarater reliability assessment. Twenty-one of the subjects returned individually on separate days to be measured aga in, so that temporal reliability could be assessed. Spearman's correla tion coefficients were 0.73 for interrater reliability 0.74 and 0.55 f or intrarater reliability, and 0.82 for temporal reliability. Overall, reliability of the MAS for assessing plantarflexor spasticity in pati ents with traumatic brain injury was found to be minimally adequate to support its continued use. However, interrater reliability was less t han that which has been reported for elbow flexors, and intrarater rel iability findings were mixed.