Li F, Wu Y, Li X
Department of Rehabilitation, Huashan Hospital, Fudan University, Shanghai, China -
Eur J Phys Rehabil Med. 2014 Feb;50(1):9-15. Epub 2013 Dec 5.
The most commonly used tools for the assessment of spasticity are the Modified Ashworth Scale and Modified Tardieu Scale, but the results on the reliability of both scales keep equivocal.
To evaluate the test-retest reliability and inter-rater reliability of the Modified Tardieu Scale (MTS) and Modified Ashworth Scale (MAS) in hemiplegic patients with stroke.
Cross-sectional study.
Inpatients referred to a rehabilitation hospital.
Fifty-one inpatients with hemiplegic stroke.
MTS and MAS were collected from the affected elbow flexors and ankle plantar flexors by: 1) two raters who were blinded to the results of the other assessment. 2) one rater one day apart.
In the MAS measurement, the inter-rater and intra-rater Kappa values were 0.66 and 0.69 for the elbow flexors, 0.48 and 0.48 for the plantar flexors, respectively. In the angle measurement of the MTS, the inter-rater and intra-rater ICCs were between 0.58-0.89 for the R1 and R2, and between 0.62-0.70 for the R1-R2.
The MAS provided moderate to substantial test-retest reliability and inter-rater reliability in the spasticity/tone measurement. The agreement of MAS elbow flexors scores was higher than that of plantar flexors scores. The reliability of angle measurement in the MTS was insufficient.
Further work should avoid observing error when taking advantage of angle difference on measuring spasticity.
评估痉挛最常用的工具是改良Ashworth量表和改良Tardieu量表，但这两种量表的可靠性结果一直存在争议。
评估改良Tardieu量表（MTS）和改良Ashworth量表（MAS）在偏瘫性脑卒中患者中的重测信度和评定者间信度。
横断面研究。
转至康复医院的住院患者。
51例偏瘫性脑卒中住院患者。
通过以下方式从患侧肘屈肌和踝跖屈肌收集MTS和MAS：1）两名对另一项评估结果不知情的评定者。2）一名评定者在相隔一天的时间进行评估。
在MAS测量中，肘屈肌的评定者间和评定者内Kappa值分别为0.66和0.69，跖屈肌分别为0.48和0.48。在MTS的角度测量中，R1和R2的评定者间和评定者内ICC在0.58 - 0.89之间，R1 - R2在0.62 - 0.70之间。
MAS在痉挛/肌张力测量中提供了中度至高度的重测信度和评定者间信度。MAS肘屈肌评分的一致性高于跖屈肌评分。MTS角度测量的可靠性不足。
在利用角度差异测量痉挛时，进一步的工作应避免观察误差。
