Reliability of a new scale for measurement of spasticity in stroke patients.

Abstract

OBJECTIVES: To evaluate the reliability of a new scale, the Triple Spasticity Scale (TSS), for assessing spasticity in stroke, through measurement of affected elbow flexors and ankle plantar flexors of hemiplegic patients with stroke, and to compare the new scale with commonly used scales. DESIGN: Cross-sectional study. SETTING: Inpatients at a rehabilitation hospital. PATIENTS: Seventy-one inpatients with hemiplegic stroke. MAIN OUTCOME MEASURES: TSS, Modified Ashworth Scale (MAS) and Modified Tardieu Scale (MTS). RESULTS: Test-retest reliability for TSS total score was good (intraclass correlation coefficient (ICC) = 0.905~0.918). Inter- rater reliability for TSS total score was also good (ICC =  0.778~0.885). Spearman's correlation coefficient demonstrated significant correlation between the TSS and MAS, in both elbow flexors and plantar flexors (r = 0.840~0.946, p = 0.000), and between the TSS and MTS, in both elbow flexors and plantar flexors (r = 0.715~0.795, p = 0.000). There were small, but significant, correlations between the scores for increased resistance and dynamic muscle length in these 2 muscles (r = 0.307~0.564, p = 0.000~0.009). CONCLUSION: The TSS has good test-retest reliability and inter-rater reliability in measurement of muscle tone. This new scale provides an alternative for measuring spasticity, which avoids some of the shortcomings of previous scales.