title: Inter-rater reliability of the Modified Modified Ashworth Scale as a clinical tool in measurements of post-stroke elbow flexor spasticity.
abstract: Patients with neurological conditions may be affected by spasticity. The Modified Modified Ashworth Scale (MMAS) is a clinical tool used to measure spasticity. The purpose of the present study was to investigate the inter-rater reliability of the MMAS during the assessment of elbow flexor spasticity in adult patients with post-stroke hemiplegia. Twenty-one adult patients with stroke (5 women, 16 men) with a median age of 60 years (interquartile range, 47-68) were tested. Elbow flexors on the affected side were examined. Inter-rater reliability for two inexperienced raters was very good. The weighted Kappa value was 0.81 (Standard Error = 0.097, 95% CI: 0.62-1.00, p = 0.0002). The weighted percentage agreement was 97.4%. The agreement between raters occurred mostly on score 1 (38.1%) followed by score 0 (23.8%). The MMAS yielded reliable measurements between raters when used on patients post-stroke with elbow flexor spasticity.
authors.affiliation: Faculty of Rehabilitation, Tehran University of Medical Sciences, Iran. nakhostin@sina.tums.ac.ir
authors.forename: Noureddin Nakhostin
authors.initials: NN
authors.lastname: Ansari
authors.forename: Soofia
authors.initials: S
authors.lastname: Naghdi
authors.forename: Scott
authors.initials: S
authors.lastname: Hasson
authors.forename: Atefeh
authors.initials: A
authors.lastname: Mousakhani
authors.forename: Azam
authors.initials: A
authors.lastname: Nouriyan
authors.forename: Zeinab
authors.initials: Z
authors.lastname: Omidvar
mesh_terms: D000328:Adult; D000368:Aged; D002983:Clinical Competence; D003430:Cross-Sectional Studies; D004550:Elbow; D005260:Female; D006429:Hemiplegia / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation; D006801:Humans; D008297:Male; D008875:Middle Aged; D009128:Muscle Spasticity / Q000209:etiology / Q000503:physiopathology* / Q000534:rehabilitation; D015588:Observer Variation; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D020521:Stroke / Q000150:complications* / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D013710:Tendons / Q000503:physiopathology*; D055815:Young Adult