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Reliability and Validity of the Modified Heckmatt Scale in Evaluating Muscle Changes With Ultrasound in Spasticity
Marisa C Moreta1, Alana Fleet2, Rajiv Reebye2
1Physical Medicine and Rehabilitation, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
Objectives:
To determine the reliability and validity of the Modified Heckmatt scale in assessing muscle echotexture in spasticity.
Design:
Prospective, observational, 2-center study. Two residents and 2 ultrasound experienced staff physicians each rated 100 ultrasound images that were also analyzed using quantitative gray-scale.
Setting:
Academic ambulatory spasticity clinic.
Participants:
Participants (N=50) included 45 patients with upper or lower extremity spasticity and 5 healthy references.
Interventions:
Not applicable.
Main Outcome Measures:
Modified Heckmatt scale ratings and quantitative gray-scale scores.
Results:
Inter- and intra-rater intraclass correlation coefficients were 0.76 and 0.81, respectively (P<.001), indicating good to excellent reliability. A significant relationship was found between Modified Heckmatt scores and quantitative gray-scale scores (r=0.829; P<.001).
Conclusions:
The Modified Heckmatt scale demonstrated good reliability and validity to assess the pathologic muscle changes that occur in patients with spasticity.
