Article

OBJECTIVE: To examine the intra- and interrater reliability of the Modified
Tardieu Scale (MTS) for lower limb assessment of adults with chronic neurologic
injuries. DESIGN: Single-center intra- and interrater reliability study. SETTING:
Outpatient neurorehabilitation unit. PARTICIPANTS: Adults (N=30; mean age +/- SD,
54.1+/-12.5y) with various chronic neurologic injuries and lower limb spasticity.
INTERVENTIONS: Two experienced physiotherapists performed slow (R2) and fast (R1)
passive movements for lower limb muscles half an hour apart on the same day
(interrater reliability), while a third physiotherapist took goniometric
measurements only. One physiotherapist repeated the assessment 1 to 3 days
earlier or later (intrarater reliability). Assessors qualitatively rated the
resistance to fast passive movements. MAIN OUTCOME MEASURES: Intraclass
correlation coefficients (ICCs) and limits of agreement (LOA) were calculated for
R1, R2, and R2-R1. Kappa coefficients were calculated for tibialis range of
movement and qualitative spasticity ratings. RESULTS: Intra- and interrater R1
and R2 measurements showed moderate to high reliability for the affected
hamstrings, rectus femoris, gastrocnemius, soleus (mean ICC +/- SD, .79+/-.08),
and tibialis anterior (mean kappa +/- SD, .58+/-.10). Only intrarater
measurements of the affected tibialis posterior were moderately reliable (R1=.57,
R2=.77). Seven of 16 spasticity angle measurements of the affected muscles were
moderately reliable. LOA were mostly unacceptably wide. Qualitative spasticity
ratings were moderately reliable for affected hamstrings, gastrocnemius, and
tibialis muscles (mean kappa +/- SD, .52+/-.10). CONCLUSIONS: The MTS is reliable
for assessing spasticity in most lower limb muscles of adults with chronic
neurologic injuries. Repeated MTS measurements of spasticity are best based on R1
measurements rather than spasticity angle or qualitative ratings of spasticity.
Optimally, MTS measurements should be undertaken by the same clinician.
CI - Copyright (c) 2013 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS