Related Experiment Video
Updated: Jul 18, 2026
Isokinetic Robotic Device to Improve Test-Retest and Inter-Rater Reliability for Stretch Reflex Measurements in Stroke Patients with Spasticity
Published on: June 12, 2019
Interrater reliability of Modified Ashworth Scale and Modified Tardieu Scale in children with spastic cerebral palsy
Winnie Ka Ling Yam1, Milan So Mei Leung
1Department of Paediatrics and Adolescent Medicine, Alice Ho Miu Ling Nethersole Hospital, Tai Po, Hong Kong SAR, China. wklyam@hotmail.com
Insights
The Modified Ashworth Scale and Modified Tardieu Scale showed low interrater reliability for assessing spasticity in children with cerebral palsy, suggesting caution is needed when using these measures.
Area of Science:
- Pediatrics
- Neurology
- Rehabilitation Medicine
Background:
- Spastic cerebral palsy is a common childhood neurological disorder.
- Accurate assessment of muscle tone and resistance to passive movement is crucial for effective management.
- The Modified Ashworth Scale and Modified Tardieu Scale are commonly used to quantify spasticity.
Purpose of the Study:
- To evaluate the interrater reliability of the Modified Ashworth Scale and Modified Tardieu Scale.
- To assess resistance to passive movement in children with spastic cerebral palsy.
Main Methods:
- Two raters assessed four lower limb muscle groups in 17 children with spastic cerebral palsy.
- A standardized procedure was employed for testing.
- Interrater reliability was quantified using the intraclass correlation coefficient.
Main Results:
- Both the Modified Ashworth Scale and Modified Tardieu Scale demonstrated low intraclass correlation coefficients.
- The reliability coefficients did not meet the acceptable threshold of 0.75.
- This indicates significant variability between raters.
Conclusions:
- The interrater reliability of the Modified Ashworth Scale and Modified Tardieu Scale is suboptimal for assessing spasticity in pediatric cerebral palsy.
- Clinicians should exercise caution when interpreting results from these scales.
- Further research may be needed to refine these assessment tools or explore alternative methods.
Abstract:
Resistance to passive movement in children with spastic cerebral palsy was assessed by two raters using the Modified Ashworth Scale and the Modified Tardieu Scale. Four muscle groups in the lower limbs were tested using a standardized procedure. Interrater reliability of the scales was evaluated by the intraclass correlation coefficient. Seventeen children, with a mean age of 7 years 9 months, were included. Two children were rated twice. The intraclass correlation coefficients of both scales were low and did not reach the acceptable limit of 0.75. Caution should be used when these scales are applied.
