Modified Ashworth Scale

평가목적

-중추신경계 병변이나 신경성 질환이 있는 환자의 경직성을 측정하기 위함

-(passive soft-tissue stretching 시)수동적으로 연부조직을 움직일 때 경직에 대한 임상가의 평가를

보조할 수 있는 빠르고 쉬운 측정

>>passive soft-tissue stretching 그냥 번역 안 하고 말하는 게 나을지도…

신뢰도와 타당도(논문기반)

1. Reliability of the Modified Ashworth Scale After Stroke for 13 Muscle Groups (논문 제목임!)
-interrater reliability(평가자 간 신뢰도) (Vidmar, T., Goljar Kregar, N., Puh, U., 2023)

상지(upper limb): 0.25~0.66

하지(lower limb): 0.41~0.54

-intrarater reliability(평가자 내 신뢰도)

상지(upper limb): 0.71~0.94

하지(lower limb): 0.55~0.97

https://www.sciencedirect.com/science/article/pii/S0003999323002484

2. Feasibility, test–retest reliability, and interrater reliability of the Modified Ashworth Scale and
Modified Tardieu Scale in persons with profound intellectual and multiple disabilities
-평가자간신뢰도 (Waninge, A., Rook, R.A., Dijkhuizen, A. , Gielen, E., van der Schans, C.P., 2011)

상지: 0.893(ICC)

하지: 0.895(ICC)

-평가자내신뢰도(표는 없고 논문에 언급은 됨)

0.78~0.82

-test-retest reliability(검사-재검사 신뢰도)

상지: 0.853(ICC)

하지: 0.813(ICC)

https://www.sciencedirect.com/science/article/pii/S0891422210003033

-concurrent validity(동시 타당도)

Correlation between the modified Ashworth Scale and resistance to passive movement: 0.511

(Pandyan, Anand D, Price, Christopher IM, Barnes, Michael P, Johnson, Garth R, 2003)

수동적 움직임에 대한 저항과 MAS 사이의 상관성(MAS 가 수동적 움직임에 대한 저항을 얼마나 잘
평가하는지….PROM 범위에서 움직였을 때 경직이 얼마나 있는지 평가하는 거니까 맞는듯)

Correlation between the modified Ashworth scale and quantitative spasticity measures:
0.385~0.486(Allison, Stephen.C, Abraham, Lawrence. D, 1995)

경직의 양적 측정과 MAS 사이의 상관성(MAS 가 경직의 양적 측정을 얼마나 잘 하는지….)

+평가자간신뢰도: 일관성(consistency)을 나타내는 것으로 평가자들이 평가한 값들의 상관관계 정도

또는 균형적인 관계를 의미함

+평가자내신뢰도: 한명의 평가자가 하나의 검사를 여러 번 시행할 때 얼마나 일관성 있게

평가하는지를 나타냄

+동시타당도: 평가가 측정 기준을 얼마나 잘 예측하는지를 나타내는 타당도

예) 새로 개발한 치매 여부를 측정하는 척도의 측정결과와 치매 전문의가 노인을 진단한 결과와의

상관관계를 보는 것>>>걍 둘의 연관성 보는 거라고 이해하면 될 듯

https://www.proquest.com/docview/200738830?accountid=15179

https://www.scopus.com/record/display.uri?eid=2-s2.0-

대상환자군(논문기반)

-경직을 동반하는 신경성 질환들

o Cerebral palsy(Yam, Winnie Ka Ling ; Leung, Milan So Mei, 2006)

o Traumatic Brain Injury(ALLISON, S. C. ; ABRAHAM, L. D. ; PETERSEN, C. L. 1996)

o Stroke(Blackburn, Marjan ; van Vliet, Paulette ; Mockett, Simon P, 2002)

o Spinal Cord Injury(Haas, B M Bergstr&ouml m, E Jamous, A Bennie, A, 1996)

o Multiple Sclerosis(Leslie, GC ; Muir, Catherine ; Part, NJ ; Roberts, RC, 1992)

Reference:

Yam, Winnie Ka Ling ; Leung, Milan So Mei/2006/Interrater Reliability of Modified Ashworth Scale and
Modified Tardieu Scale in Children With Spastic Cerebral Palsy/Journal of child neurology v.21
no.12 /p.1031 - 1035

ALLISON, S. C. ABRAHAM, L. D. PETERSEN, C. L./1996/Reliability of the Modified Ashworth Scale

in the assessment of plantarflexor muscle spasticity in patients with traumatic brain injury/International
journal of rehabilitation research = Internationale Zeitschrift für Rehabilitationsforschung v.19
no.1/p.67 - 78

Blackburn, Marjan ; van Vliet, Paulette ; Mockett, Simon P/2002/Reliability of Measurements

Obtained With the Modified Ashworth Scale in the Lower Extremities of People With Stroke/Physical
therapy v.82 no.1/p.25 - 34

Haas, B M Bergstr&ouml m, E Jamous, A Bennie, A/1996/The inter rater reliability of the original and
of the modified Ashworth scale for the assessment of spasticity in patients with spinal cord
injury/Spinal cord : the official journal of the International Medical Society of Paraplegia v.34
no.9/p.560 - 564

Leslie, GC ; Muir, Catherine ; Part, NJ ; Roberts, RC/1992/A comparison of the assessment of

spasticity by the Wartenberg pendulum test and the Ashworth grading scale in patients with multiple
sclerosis/Clinical rehabilitation v.6 no.1/p.41 – 48

Noureddin Nakhostin Ansari, Soofia Naghdi, Tahereh Khosravian Arab and Shohreh
Jalaie/2008/The interrater and intrarater reliability of the Modified Ashworth Scale in the
assessment of muscle spasticity: Limb and muscle group effect/NeuroRehabilitation vol.23/p.231–
237

Vidmar, T., Goljar Kregar, N., Puh, U./2023/Reliability of the Modified Ashworth Scale After Stroke
for 13 Muscle Groups/Archives of Physical Medicine and Rehabilitation/doi:
10.1016/j.apmr.2023.04.008

Stephen C. Allison, Lawrence D. Abraham/1995/Correlation of quantitative measures with the

modified Ashworth scale in the assessment of plantar flexor spasticity in patients with traumatic
brain injury/Journal of Neurology vol.242/p.699-706

Waninge, A., Rook, R.A., Dijkhuizen, A. , Gielen, E., van der Schans, C.P./2011/Feasibility, test–retest
reliability, and interrater reliability of the Modified Ashworth Scale and Modified Tardieu Scale in
persons with profound intellectual and multiple disabilities/In Research in Developmental
Disabilities 32(2)/p. 613-620

Pandyan, Anand D, Price, Christopher IM, Barnes, Michael P, Johnson, Garth R/2003/A
biomechanical investigation into the validity of the modified Ashworth Scale as a measure of
elbow spasticity/Clinical Rehabilitation vol.17/p.290-294
Bohannon RW, Smith MB./1987/Interrater reliability of a modified Ashworth scale of muscle
spasticity/ Physical Therapy vol.67(2)/p.206-207.