Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran.
Research Center for War-affected People, Tehran University of Medical Sciences, Tehran, Iran.
J Pediatr Rehabil Med. 2022;15(1):151-158. doi: 10.3233/PRM-190648.
The aim of the study was to investigate the inter- and intra-rater reliability of the Modified Modified Ashworth Scale (MMAS) in the assessment of lower extremity spasticity in children with spastic cerebral palsy (CP).
Fifteen children (10 boys) with a mean age of 8.7±3.4 years participated. Two physiotherapists rated the spasticity of the hip adductors, knee extensors, and ankle plantar flexors for inter-rater reliability. Each child was examined again by one of the physiotherapists (same physiotherapist for all of the children) for intra-rater reliability (mean interval = 7 days). A random sequence of raters and muscles tested was applied.
The reliability of the intraclass correlation coefficients (ICC) for individual muscle groups ranged between good to excellent (ICCagreement of 0.60-0.83). The ICC values for overall inter-rater (ICCagreement = 0.82) and intra-rater reliability (ICCagreement = 0.85) were excellent.
The MMAS showed excellent reliability for the assessment of lower extremity muscle spasticity in children with cerebral palsy. However, an interpretation should be made with caution due to the small sample size and wide range of confidence interval values.
本研究旨在探讨改良 Modified Ashworth 量表（MMAS）在评估痉挛性脑瘫儿童下肢痉挛中的组内和组间可靠性。
15 名儿童（男 10 名），平均年龄 8.7±3.4 岁。两名物理治疗师评估髋关节内收肌、膝关节伸肌和踝关节跖屈肌的痉挛程度，以评估组间可靠性。所有儿童均由其中一名物理治疗师（所有儿童均由同一名物理治疗师）进行再次评估，以评估组内可靠性（平均间隔 7 天）。采用随机的评估者和肌肉测试顺序。
个体肌肉群的组内相关系数（ICC）的可靠性范围为良好至优秀（ICC 一致性为 0.60-0.83）。总体组间（ICC 一致性为 0.82）和组内可靠性（ICC 一致性为 0.85）的 ICC 值均为优秀。
MMAS 显示出评估脑瘫儿童下肢肌肉痉挛的优异可靠性。然而，由于样本量小且置信区间值范围较宽，因此应谨慎解释。
