Feasibility, test-retest reliability, and interrater reliability of the Modified Ashworth Scale and Modified Tardieu Scale in persons with profound intellectual and multiple disabilities

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Caregivers of persons with profound intellectual and multiple disabilities (PIMD) often describe the quality of the daily movements of these persons in terms of flexibility or stiffness. Objective outcome measures for flexibility and stiffness are muscle tone or level of spasticity. Two instruments used to grade muscle tone and spasticity are the Modified Ashworth Scale (MAS) and the Modified Tardieu Scale (MTS). To date, however, no research has been performed to determine the psychometric properties of the MAS and MTS in persons with PIMD. Therefore, the purpose of this study was to determine the feasibility, test-retest reliability, and interrater reliability of the MAS and MTS in persons with PIMD. We assessed 35 participants on the MAS and MTS twice, first for the test and second a week later for the retest. Two observers performed the measurements. Feasibility was assessed based on the percentage of successful measurements. Test-retest and interrater reliability were determined by using the Wilcoxon signed rank test, intraclass correlation coefficients (ICC), Spearman's correlation, and either limits of agreement (LOA) or quadratically weighted kappa. The feasibility of the measurements was good, because an acceptable percentage of successful measurements were performed. MAS measurements had substantial to almost perfect quadratically weighted kappa (>0.8) and an acceptable ICC (>0.8) for both inter- and intrarater reliability. However, MTS measurements had insufficient ICCs, Spearman's correlations, and LOAs for both inter- and interrater reliability. Our data indicated that the feasibility of the MAS and MTS for measuring muscle tone in persons with PIMD was good. The MAS had sufficient test-retest and interrater reliability; however, the MTS had an insufficient test-retest and interrater reliability in persons with PIMD. Thus, the MAS may be a good method for evaluating the quality of daily movements in persons with PIMD. Providing test administrators with training and clear instructions will improve test reliability.

Original languageEnglish
Pages (from-to)613-620
JournalResearch in developmental disabilities
Volume32
Issue number2
DOIs
Publication statusPublished - 12 Jan 2011

Keywords

  • adult
  • disability evaluation
  • feasibility studies
  • female
  • humans
  • intellectual disability
  • male
  • middle aged
  • motor skills disorders
  • muscle spasticity
  • neurologic examination
  • observer variation
  • Reproducibility of Results
  • severity of Illness index
  • clinical trial
  • Research Support, Non-U.S. Gov't
  • validation studies

Cite this

@article{76301dd33c76424c8d755f1a550d2f68,
title = "Feasibility, test-retest reliability, and interrater reliability of the Modified Ashworth Scale and Modified Tardieu Scale in persons with profound intellectual and multiple disabilities",
abstract = "Caregivers of persons with profound intellectual and multiple disabilities (PIMD) often describe the quality of the daily movements of these persons in terms of flexibility or stiffness. Objective outcome measures for flexibility and stiffness are muscle tone or level of spasticity. Two instruments used to grade muscle tone and spasticity are the Modified Ashworth Scale (MAS) and the Modified Tardieu Scale (MTS). To date, however, no research has been performed to determine the psychometric properties of the MAS and MTS in persons with PIMD. Therefore, the purpose of this study was to determine the feasibility, test-retest reliability, and interrater reliability of the MAS and MTS in persons with PIMD. We assessed 35 participants on the MAS and MTS twice, first for the test and second a week later for the retest. Two observers performed the measurements. Feasibility was assessed based on the percentage of successful measurements. Test-retest and interrater reliability were determined by using the Wilcoxon signed rank test, intraclass correlation coefficients (ICC), Spearman's correlation, and either limits of agreement (LOA) or quadratically weighted kappa. The feasibility of the measurements was good, because an acceptable percentage of successful measurements were performed. MAS measurements had substantial to almost perfect quadratically weighted kappa (>0.8) and an acceptable ICC (>0.8) for both inter- and intrarater reliability. However, MTS measurements had insufficient ICCs, Spearman's correlations, and LOAs for both inter- and interrater reliability. Our data indicated that the feasibility of the MAS and MTS for measuring muscle tone in persons with PIMD was good. The MAS had sufficient test-retest and interrater reliability; however, the MTS had an insufficient test-retest and interrater reliability in persons with PIMD. Thus, the MAS may be a good method for evaluating the quality of daily movements in persons with PIMD. Providing test administrators with training and clear instructions will improve test reliability.",
keywords = "adult, disability evaluation, feasibility studies, female, humans, intellectual disability, male, middle aged, motor skills disorders, muscle spasticity, neurologic examination, observer variation, Reproducibility of Results, severity of Illness index, clinical trial, Research Support, Non-U.S. Gov't, validation studies, volwassene, handicap evaluatie, haalbaarheidsstudies, vrouwelijk, mensen, verstandelijk gehandicapten, mannelijk, middelbaar, motorische stoornissen, spier spasticiteit, neurologisch onderzoek, waarnemer variatie, reproduceerbaarheid van de resultaten, severity of Illness index, clinical trial, tijdschriftartikel, esearch support, non-U.S, validatiestudies",
author = "Aly Waninge and Rook, {R A} and Annemarie Dijkhuizen and E Gielen and {van der Schans}, Cees",
note = "Copyright {\circledC} 2010 Elsevier Ltd. All rights reserved.",
year = "2011",
month = "1",
day = "12",
doi = "10.1016/j.ridd.2010.12.013",
language = "English",
volume = "32",
pages = "613--620",
journal = "Research in developmental disabilities",
issn = "0891-4222",
publisher = "Elsevier",
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TY - JOUR

T1 - Feasibility, test-retest reliability, and interrater reliability of the Modified Ashworth Scale and Modified Tardieu Scale in persons with profound intellectual and multiple disabilities

AU - Waninge, Aly

AU - Rook, R A

AU - Dijkhuizen, Annemarie

AU - Gielen, E

AU - van der Schans, Cees

N1 - Copyright © 2010 Elsevier Ltd. All rights reserved.

PY - 2011/1/12

Y1 - 2011/1/12

N2 - Caregivers of persons with profound intellectual and multiple disabilities (PIMD) often describe the quality of the daily movements of these persons in terms of flexibility or stiffness. Objective outcome measures for flexibility and stiffness are muscle tone or level of spasticity. Two instruments used to grade muscle tone and spasticity are the Modified Ashworth Scale (MAS) and the Modified Tardieu Scale (MTS). To date, however, no research has been performed to determine the psychometric properties of the MAS and MTS in persons with PIMD. Therefore, the purpose of this study was to determine the feasibility, test-retest reliability, and interrater reliability of the MAS and MTS in persons with PIMD. We assessed 35 participants on the MAS and MTS twice, first for the test and second a week later for the retest. Two observers performed the measurements. Feasibility was assessed based on the percentage of successful measurements. Test-retest and interrater reliability were determined by using the Wilcoxon signed rank test, intraclass correlation coefficients (ICC), Spearman's correlation, and either limits of agreement (LOA) or quadratically weighted kappa. The feasibility of the measurements was good, because an acceptable percentage of successful measurements were performed. MAS measurements had substantial to almost perfect quadratically weighted kappa (>0.8) and an acceptable ICC (>0.8) for both inter- and intrarater reliability. However, MTS measurements had insufficient ICCs, Spearman's correlations, and LOAs for both inter- and interrater reliability. Our data indicated that the feasibility of the MAS and MTS for measuring muscle tone in persons with PIMD was good. The MAS had sufficient test-retest and interrater reliability; however, the MTS had an insufficient test-retest and interrater reliability in persons with PIMD. Thus, the MAS may be a good method for evaluating the quality of daily movements in persons with PIMD. Providing test administrators with training and clear instructions will improve test reliability.

AB - Caregivers of persons with profound intellectual and multiple disabilities (PIMD) often describe the quality of the daily movements of these persons in terms of flexibility or stiffness. Objective outcome measures for flexibility and stiffness are muscle tone or level of spasticity. Two instruments used to grade muscle tone and spasticity are the Modified Ashworth Scale (MAS) and the Modified Tardieu Scale (MTS). To date, however, no research has been performed to determine the psychometric properties of the MAS and MTS in persons with PIMD. Therefore, the purpose of this study was to determine the feasibility, test-retest reliability, and interrater reliability of the MAS and MTS in persons with PIMD. We assessed 35 participants on the MAS and MTS twice, first for the test and second a week later for the retest. Two observers performed the measurements. Feasibility was assessed based on the percentage of successful measurements. Test-retest and interrater reliability were determined by using the Wilcoxon signed rank test, intraclass correlation coefficients (ICC), Spearman's correlation, and either limits of agreement (LOA) or quadratically weighted kappa. The feasibility of the measurements was good, because an acceptable percentage of successful measurements were performed. MAS measurements had substantial to almost perfect quadratically weighted kappa (>0.8) and an acceptable ICC (>0.8) for both inter- and intrarater reliability. However, MTS measurements had insufficient ICCs, Spearman's correlations, and LOAs for both inter- and interrater reliability. Our data indicated that the feasibility of the MAS and MTS for measuring muscle tone in persons with PIMD was good. The MAS had sufficient test-retest and interrater reliability; however, the MTS had an insufficient test-retest and interrater reliability in persons with PIMD. Thus, the MAS may be a good method for evaluating the quality of daily movements in persons with PIMD. Providing test administrators with training and clear instructions will improve test reliability.

KW - adult

KW - disability evaluation

KW - feasibility studies

KW - female

KW - humans

KW - intellectual disability

KW - male

KW - middle aged

KW - motor skills disorders

KW - muscle spasticity

KW - neurologic examination

KW - observer variation

KW - Reproducibility of Results

KW - severity of Illness index

KW - clinical trial

KW - Research Support, Non-U.S. Gov't

KW - validation studies

KW - volwassene

KW - handicap evaluatie

KW - haalbaarheidsstudies

KW - vrouwelijk

KW - mensen

KW - verstandelijk gehandicapten

KW - mannelijk

KW - middelbaar

KW - motorische stoornissen

KW - spier spasticiteit

KW - neurologisch onderzoek

KW - waarnemer variatie

KW - reproduceerbaarheid van de resultaten

KW - severity of Illness index

KW - clinical trial

KW - tijdschriftartikel

KW - esearch support, non-U.S

KW - validatiestudies

U2 - 10.1016/j.ridd.2010.12.013

DO - 10.1016/j.ridd.2010.12.013

M3 - Article

VL - 32

SP - 613

EP - 620

JO - Research in developmental disabilities

JF - Research in developmental disabilities

SN - 0891-4222

IS - 2

ER -