Mishra Chittaranjan, Ganesh G Shankar
SVNIRTAR, Olatpur, PO Bairoi, Cuttack Dt, Odisha, 754010, India.
Physiother Res Int. 2014 Dec;19(4):231-7. doi: 10.1002/pri.1588. Epub 2014 Mar 12.
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.
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.
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.
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).
The MMAS has good inter-rater reliability in the assessment of plantar flexor muscle spasticity in patients with SCI.
痉挛发生于中枢神经系统疾病中，如中风、脊髓损伤（SCI）、多发性硬化症和创伤性脑损伤。最近开发的用于测量痉挛的临床方法是改良版改良Ashworth量表（MMAS）。研究目的：本研究的目的是确定MMAS在评估SCI患者跖屈肌痉挛时的评分者间信度。
招募了38名受试者（32名男性和6名女性，平均年龄31.9±12.6岁）参与研究。排除下肢挛缩患者以及被动运动禁忌患者。
每位患者在一次评估中由两名评分者进行评估。第一名评估者完成评估程序并使用MMAS对患者肌张力进行评分后，第二名评估者在1小时后重复相同程序。评估在侧卧位进行。通过非加权Cohen kappa分析一致性程度。
评分者之间的一致性良好（比目鱼肌 - κ：0.75，标准误 = 0.084，p < 0.0001，腓肠肌 - κ：0.70，标准误 = 0.105，p < 0.0001）。
MMAS在评估SCI患者跖屈肌痉挛时具有良好的评分者间信度。
