School of Kinesiology, Shanghai University of Sport, Shanghai, China
Department of Physiotherapy, Guy's and St Thomas' NHS Foundation Trust, London, UK.
BMJ Open. 2021 Dec 24;11(12):e050711. doi: 10.1136/bmjopen-2021-050711.
To evaluate published evidence on the Modified Tardieu Scale (MTS) as a tool to assess spasticity in the upper limbs of adults with neurological conditions.
A systematic search of six electronic databases (PubMed/MEDLINE, CINAHL, EMBASE, the Cochrane Library, Web of Science and Physiotherapy Evidence Database) from inception to 31 December 2020. A search strategy was developed using key elements of the research question: population, intervention (action), outcome.
Inclusion criteria: (1) adult participants with neurological conditions; (2) upper limb muscles/joints as tested elements; (3) studies testing the MTS and (4) reliability or validity reported.
(1) non-English articles; (2) non-empirical articles and (3) studies testing the Tardieu Scale.
Evidence quality was evaluated using the US National Heart, Lung, Blood Institute quality assessment tool for observational cohort and cross-sectional studies.
Six reliability studies met the inclusion criteria. Overall, most articles reported good-to-excellent levels of inter-rater, intrarater and test-retest reliability. However, limitations, such as study design weaknesses, statistical misuses and reporting biases, undermine confidence in reported conclusions. The validity of the MTS also remained questionable based on the results of one study.
This review did not find sufficient evidence to either support or reject the use of the MTS in assessing spasticity in the upper limbs of adults with neurological conditions. Despite the paucity of research evidence, the MTS may still remain a clinically useful tool to measure the motor aspect of spasticity. Future research would benefit from a focus on test standardisation, while the wider field would require the development of a consensual definition of spasticity.
评估已发表的关于改良 Tardieu 量表（MTS）作为评估成人神经疾病上肢痉挛的工具的证据。
从开始到 2020 年 12 月 31 日，对六个电子数据库（PubMed/MEDLINE、CINAHL、EMBASE、Cochrane 图书馆、Web of Science 和 Physiotherapy Evidence Database）进行了系统检索。使用研究问题的关键要素制定了搜索策略：人群、干预（行动）、结果。
纳入标准：（1）患有神经疾病的成年参与者；（2）以上肢肌肉/关节为测试要素；（3）测试 MTS 的研究；（4）报告可靠性或有效性。
（1）非英文文章；（2）非实证文章；（3）测试 Tardieu 量表的研究。
使用美国国立心肺血液研究所用于观察性队列和横断面研究的质量评估工具评估证据质量。
六项可靠性研究符合纳入标准。总体而言，大多数文章报告了很好到很好的观察者间、观察者内和重测信度。然而，研究设计缺陷、统计误用和报告偏倚等局限性削弱了对报告结论的信心。根据一项研究的结果，MTS 的有效性也仍然存在疑问。
本综述没有发现足够的证据来支持或反对在评估成人神经疾病上肢痉挛时使用 MTS。尽管研究证据不足，但 MTS 可能仍然是衡量痉挛运动方面的一种有用的临床工具。未来的研究将受益于对测试标准化的关注，而更广泛的领域将需要制定痉挛的共识定义。
