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Ashworth Spasticity Scale (and Modified Version)

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Encyclopedia of Clinical Neuropsychology

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Synonyms

AS; MAS

Description

The Ashworth Scale (AS) and Modified Ashworth Scale (MAS) measure spasticity. During the administration of both AS (Ashworth 1964) and MAS (Bohannon and Smith 1987), the examiner passively moves the joint being tested and rates the perceived level of resistance in the muscle groups opposing the movement. Both scales are single-item measures ranging from 0 to 4, where 0 indicates no increase in muscle tone and 4 indicates that the affected part is rigid in flexion or extension. The AS is considered an ordinal scale, whereas the MAS is considered a nominal scale due to ambiguity created by the addition of the 1+ grade between 1 and 2 (Pandyan et al. 1999).

Historical Background

The AS was first described by Ashworth in 1964 (Ashworth 1964) and was subsequently modified with the addition of a 1+ grade by Bohannon in 1987 with the intent to increase sensitivity (Bohannon and Smith 1987). However, this addition may have decreased the reliability of the MAS for...

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References and Readings

  • Ansari, N. N., Naghdi, S., Arab, T. K., & Jalaie, S. (2008). The interrater and intrarater reliability of the modified Ashworth scale in the assessment of muscle spasticity: Limb and muscle group effect. NeuroRehabilitation, 23(3), 231–237.

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  • Ashworth, B. (1964). Preliminary trial of carisoprodol in multiple sclerosis. Practitioner, 192, 540–542.

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  • Bohannon, R. W., & Smith, M. B. (1987). Interrater reliability of a modified Ashworth scale of muscle spasticity. Physical Therapy, 67(2), 206–207.

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  • Fleuren, J. F., Voerman, G. E., Erren-Wolters, C. V., et al. (2009). Stop using the Ashworth scale for the assessment of spasticity. Journal of Neurology, Neurosurgery, and Psychiatry, 81(2), 46–52.

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  • Lance, J. W. (1980). Symposium synopsis. In R. G. Feldman, R. R. Young, & W. P. Koella (Eds.), Spasticity: Disordered motor control (pp. 485–494). Chicago: Year Book Medical Publishers.

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  • Pandyan, A., Johnson, G., Price, C., Curless, R., Barnes, M., & Rodgers, H. (1999). A review of the properties and limitations of the Ashworth and modified Ashworth scales as measures of spasticity. Clinical Rehabilitation, 13(5), 373–383.

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  • Pandyan, A. D., Gregoric, M., Barnes, M. P., et al. (2005). Spasticity: Clinical perceptions, neurological realities and meaningful measurement. Disability and Rehabilitation, 27(1–2), 2–6.

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  • Platz, T., Eickhof, C., Nuyens, G., & Vuadens, P. (2005). Clinical scales for the assessment of spasticity, associated phenomena, and function: A systematic review of the literature. Disability and Rehabilitation, 27(1–2), 7–18.

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Author information

Authors and Affiliations

  1. Department of Rehabilitation Sciences, University of Cincinnati, Cincinnati, OH, USA

    Kari Dunning

Authors
  1. Kari Dunning
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Corresponding author

Correspondence to Kari Dunning .

Editor information

Editors and Affiliations

  1. Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA, USA

    Jeffrey S. Kreutzer

  2. Kessler Foundation, Pleasant Valley Way, West Orange, NJ, USA

    John DeLuca

  3. Independent Practice, Wynnewood, PA, USA

    Bruce Caplan

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Dunning, K. (2018). Ashworth Spasticity Scale (and Modified Version). In: Kreutzer, J.S., DeLuca, J., Caplan, B. (eds) Encyclopedia of Clinical Neuropsychology. Springer, Cham. https://doi.org/10.1007/978-3-319-57111-9_1792

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