Abstract:
Objective: There are some controversies about the value of modified Ashworth Scale (MAS) for assessing spasticity. The goal of this study was to investigate if there is any correlation between scores obtained from MAS for wrist spasticity and electrophysiological recordings as the objective measure of spasticity. Methods: In this cross-sectional study, 34 stroke patients were employed. Wrist spasticity was clinically measured by means of MAS. Also, an electromyogram (EMG) machine was used to elicit Hmax and Mmax from the flexor carpi radialis muscle. Spearman’s correlation coefficient test was used to investigate potential correlation between clinically and electrophysiologically measures of spasticity. Results: The observed relation between MAS and EMG recordings was not statistically significant (rho=0.183 P>0.05). Discussion: Our findings suggest that MAS may be a useful tool for grading hypertonia, but it is not a valid measure of spasticity in selected patients.
Machine summary:
Validity of Modified Ashworth Scale as a Measure of Wrist Spasticity in Stroke Patients Mohammad Heidari, MSc Department of Occupational Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran Shahram Abootalebi*, MD University of Social Welfare and Rehabilitation Sciences, Pediatric Neurorehabilitation Research Center, Tehran, Iran Seyed Ali Hosseini, PhD Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran There are some controversies about the value of modified Ashworth Scale (MAS) for assessing spasticity.
ir 26 Vol. 9 – No. 13 studies (9, 14, 15), some authors still claim that MAS can not be a valid tool for assessing spasticity because of low ability of this scale for discriminating spasticity from the other factors contribute to hypertonia (mostly biomechanical changes in involved muscles) seen after central neurological damages include stroke (12, 15, 16).
The ratio of maximum amplitudes of H reflex and its muscle response (Hmax/Mmax) is a parameter of electromyography (EMG) which used as a neurophysiological measure of spasticity (1, 9, 12, 17).
In this study we investigated the relationship between scores obtained from MAS and EMG recordings to measure wrist spasticity in stroke patients.
323 28 Vol. 9 – No. 13 Discussion This study was run to determine if there is any meaningful relationship between scores obtained from MAS and Hmax /Mmax ratio for measuring wrist spasticity in stroke patients; if so, the value of MAS as a clinical tool for measuring spasticity would be increased, because one of the main mechanisms of muscle spasticity is increased α motor neuron excitability (20-21).