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Inter-Rater and Intra-Rater Reliability of the Modified Ashworth Scale and the Modified Tardieu Scale: A Comparison Study
J Kor Soc Phys Ther 2010;22(4):29-33
Published online August 25, 2010
© 2010 The Korean Society of Physical Therapy.

Yul?Jung Choi, PT; Jung?Ah Lee, PT, PhD1; Hwa?Kyung Shin, PT, PhD2

Department of Physical Therapy, Gangnam Severance Hospital; 1Department of Motor & Cognitive Rehabilitation,
National Rehabilitation Center Research Institute; 2Department of Physical therapy, College of Medical Science, Catholic
University of Daegu
Abstract
Purpose: The purpose of this study was to assess and compare the reliability of the Modified Tardieu Scale (MTS) with the Modified Ashworth Scale (MAS) in patients with hemiplegia.
Methods: Two experienced physical therapists examined twenty six patients (17 male and 9 female) with an age range of 19-83 years (mean=51.9 SD=15.2). They assessed the elbow flexor/extensor muscle spasticity in the affected side. Interand intra-rater reliability of the MAS and the MTS were calculated using kappa statistics. Intraclass correlation coefficient
(ICC) was calculated to determine the inter-and -rater reliability of the angle of muscle reactions (R2-R1).
Results: The intra-rater reliability of the MAS (K=0.39-0.55) and MTS (K=0.33-0.55) was fair to moderate. The inter-rater reliability was significantly higheras measured with MTS (K=0.54-0.66) in comparison with MAS (K=0.52). Intra-rater reliability of R2-R1 was moderate to almost perfect (ICC=0.52-0.86), and inter-rater reliability was substantial (ICC=0.74-0.76).
Conclusion: The MTS provides higher inter-rater reliability compared with the MAS in hemiplegia patient analysis, but intra-rater reliability of both scales was not significantly different. Thus further research is needed to examine not only reliability, but also validity of these measurement systems.
Keywords : Plasticity, Functional MRI, Motor learning, Modified ashworth scale, Modified tardieu scale, Reliability, Spasticity


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