Article

The aim of this study was to investigate the intra-rater reliability of the
Modified Modified Ashworth Scale (MMAS) in the upper limb of patients with
hemiparesis and to determine the effect of pain and contracture presence on the
reliability of the MMAS.
For this test-retest study 30 patients with hemiparesis
were included. One physiotherapist using the MMAS, randomly rated the spasticity
of shoulder adductors, elbow flexors, and wrist flexors in the affected upper
limb of each patient with hemiparesis twice with at least a 1 week interval
between testing sessions. The presence of pain and contracture during passive
stretch was recorded. The magnitude of the contracture was measured by a
goniometer. The quadratic weighted kappa statistics was very good for the upper
limb spasticity (kappaw= 0.84). Intra-rater reliability was good for shoulder
adductors (kappaw=0.75), and very good for elbow flexors and wrist flexors
(kappaw 0.86 and 0.90, respectively). There were no differences between the
weighted kappa values for muscle groups (p>0.05).
The intra-rater reliability was
also good in the presence of pain or contracture. The MMAS had very good
intra-rater reliability in the assessment of upper limb spasticity in patients
with hemiparesis. The presence of pain during shoulder abduction or contracture
of the shoulder adductors had no influence on the reliability of the MMAS (kappa
w=0.75, 0.77, respectively).

Langue : ANGLAIS