Validation of the modified Ashworth scale in Russia

Natalya A. Suponeva; Супонева Наталья Александровна; Dzhamilya G. Yusupova; Юсупова Джамиля Гереевна; Kseniya A. Ilyina; Ильина Ксения Александровна; Danila A. Melchenko; Мельченко Данила Александрович; Anastasiya A. Butkovskaya; Бутковская Анастасия Александровна; Ekaterina S. Zhirova; Жирова Екатерина Станиславовна; Anna S. Taratukhina; Таратухина Анна Сергеевна; Aleksey A. Zimin; Зимин Алексей Алексеевич; Aleksandr B. Zaitsev; Зайцев Александр Борисович; Anton S. Klochkov; Клочков Антон Сергеевич; Roman Kh. Lyukmanov; Люкманов Роман Харисович; Artem M. Kotov-Smolensky; Котов-Смоленский Артем Михайлович; Anastasia E. Khizhnikova; Хижникова Анастасия Евгеньевна; Guzel A. Gatina; Гатина Гузэль Амировна; Mansur A. Kutlubaev; Кутлубаев Мансур Амирович; Mikhail A. Piradov; Пирадов Михаил Александрович

doi:10.25692/ACEN.2020.1.10

Validation of the modified Ashworth scale in Russia

Authors: Suponeva N.A.¹, Yusupova D.G.¹, Ilyina K.A.², Melchenko D.A.³, Butkovskaya A.A.¹, Zhirova E.S.¹, Taratukhina A.S.¹, Zimin A.A.¹, Zaitsev A.B.⁴, Klochkov A.S.¹, Lyukmanov R.K.¹, Kotov-Smolensky A.M.¹, Khizhnikova A.E.¹, Gatina G.A.⁵, Kutlubaev M.A.⁶, Piradov M.A.¹
Affiliations:
1. Research Center of Neurology
2. Lomonosov Moscow State University
3. Peoples' Friendship University of Russia
4. I.M. Sechenov First Moscow State Medical University
5. Dagestan State Medical University
6. Bashkir State Medical University
Issue: Vol 14, No 1 (2020)
Pages: 89-96
Section: Technologies
URL: https://journal-vniispk.ru/2075-5473/article/view/124217
DOI: https://doi.org/10.25692/ACEN.2020.1.10
ID: 124217

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Abstract
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Abstract

Spasticity after stroke is a factor that causes disability and restricts activities of daily living, and represents a problem for both doctors and patients’ relatives. At the present time, the modified Ashworth scale (MAS) is a useful method of assessing increased muscle tone in patients after a cerebrovascular incident.

The aim of the work is the linguistic and cultural adaptation of the MAS, with subsequent evaluation of its psychometric properties.

Materials and methods. The study included 50 patients. The validation procedure consisted of linguistic and cultural adaptation and evaluation of the psychometric properties of the Russian language version of the MAS. Test-retest was used to examine reliability (calculating Spearman’s rank correlation coefficient) and Cohen’s kappa coefficient was used to evaluate inter-rater agreement. Criterion validity was assessed by comparing the MAS results with the Spasticity Scale score of the Research Centre of Neurology. Sensitivity was measured using Wilcoxon nonparametric test, which reflects the statistical significance of intertest differences before and after rehabilitation measures.

Results. Test-retest analysis showed a significant correlation (0.87) between reassessment results. Inter-rater reliability was average (0.56), which confirms the scale’s subjectivity and proves that patient assessment over time should be performed by the same investigator whenever possible. The correlation coefficient between the MAS and the Spasticity Scale of the Research Centre of Neurology was 0.79. Statistically significant differences were found when patients were reassessed after rehabilitation treatment (p<0.0001).

Conclusion. The Russian version of the MAS is a valid, reliable, and sensitive instrument, which can be recommended for use in clinical practice, both for the initial assessment of spasticity and for monitoring the effect of treatment.

Keywords

validation, Russian version, Modified Ashworth Scale, spasticity, Spasticity Scale of the Research Centre of Neurology

About the authors

Natalya A. Suponeva

Research Center of Neurology

Email: dzhamilya-d@mail.ru
ORCID iD: 0000-0003-3956-6362

D. Sci. (Med.), Professor, Corresponding Member of the Russian Academy of Sciences, principal researcher, Department of neurorehabilitation and physiotherapy

Russian Federation, Moscow

D. Sci. (Med.), Professor, Academician of the Russian Academy of Sciences, Director

Russian Federation, Moscow

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