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A review of the properties and limitations of the Ashworth and modified Ashworth Scales as measures of spasticity

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TLDR
The application of both scales would suggest that confusion exists on their characteristics and limitations as measures of spasticity, and there is a need to standardize methods to apply these scales in clinical practice and research.
Abstract
Background: The Ashworth Scale and the modified Ashworth Scale are the primary clinical measures of spasticity. A prerequisite for using any scale is a knowledge of its characteristics and limitations, as these will play a part in analysing and interpreting the data. Despite the current emphasis on treating spasticity, clinicians rarely measure it.Objectives: To determine the validity and the reliability of the Ashworth and modified Ashworth Scales.Study design: A theoretical analysis following a structured literature review (key words: Ashworth; Spasticity; Measurement) of 40 papers selected from the BIDS-EMBASE, First Search and Medline databases.Conclusions: The application of both scales would suggest that confusion exists on their characteristics and limitations as measures of spasticity. Resistance to passive movement is a complex measure that will be influenced by many factors, only one of which could be spasticity. The Ashworth Scale (AS) can be used as an ordinal level measure of resistance to pa...

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Journal ArticleDOI

Correlation of Falls in Patients With Amyotrophic Lateral Sclerosis With Objective Measures of Balance, Strength, and Spasticity

TL;DR: There is a relationship between LE weakness and number of falls in the ALS population and preventing disuse-related LE muscle weakness and education of need for external support may decrease the number of fall experienced by individuals with ALS.
Journal ArticleDOI

Interpretation of surface EMGs in children with cerebral palsy: An initial study using a fuzzy expert system.

TL;DR: This first attempt to verify the feasibility and correctness of an expert system based on fuzzy inference methodology for interpreting surface EMG signals and the resulting muscular coordination patterns of ankle movement during gait shows promising results.
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Botulinum toxin A for upper limb spasticity

TL;DR: The next step is to determine exactly which subgroups of patients with cerebellar ataxia respond to riluzole and could therefore benefi t from treatment.
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Is Electrical Stimulation Beneficial for Improving the Paralytic Effect of Botulinum Toxin Type A in Children with Spastic Diplegic Cerebral Palsy

TL;DR: In this article, the authors investigated whether electrical stimulation (ES) improves the paralytic effect of botulinum toxin type A (BTX-A) and evaluated the differences between low frequency (LF) and high frequency (HF) ES in children with spastic diplegic cerebral palsy (CP).
Journal ArticleDOI

Arm motor control as predictor for hypertonia after stroke: a prospective cohort study.

TL;DR: Hypertonia develops in a large proportion of patients with stroke, predominantly within the first 3 months poststroke, and poor arm motor control is a risk factor for the development of hypertonia.
References
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Book

Nonparametric statistics for the behavioral sciences

Sidney Siegel
TL;DR: This is the revision of the classic text in the field, adding two new chapters and thoroughly updating all others as discussed by the authors, and the original structure is retained, and the book continues to serve as a combined text/reference.
Book

An introduction to categorical data analysis

Alan Agresti
TL;DR: In this paper, the authors present a tour of categorical data analysis for Contingency Tables and Logit and Loglinear models for contingency tables, as well as generalized linear models for Matched Pairs.
Journal ArticleDOI

Interrater Reliability of a Modified Ashworth Scale of Muscle Spasticity

TL;DR: The relationship between the raters' judgments was significant and the reliability was good, and it is believed these results to be positive enough to encourage further trials of the modified Ashworth scale for grading spasticity.
Book

An Introduction to Medical Statistics

Martin Bland
TL;DR: The design of experiments, analysis of the means of small samples using the t-c Distribution, and selection of the statistical method for clinical measurement and the structure of human populations are reviewed.
Book

Introduction to multivariate analysis

TL;DR: In this article, the multivariate normal distribution is used for principal component analysis and multivariate analysis of covariance and related topics, as well as multi-dimensional scaling and cluster analysis.
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