Modified Ashworth Scale for Spasticity
The modified Ashworth scale is a fundamental clinical tool to qualitatively measure increased muscle tone (spasticity) through resistance to passive movement of a joint. This scale allows health professionals to evaluate and document the degree of spasticity in pediatric patients.
Diagnostic Criteria
- 0: Normal muscle tone (no increase in tone).
- 1: Slight increase in tone manifested by a catch and release or minimal resistance at the end of the joint stroke.
- 1+: Slight increase in muscle tone manifested by minimal resistance in the remainder (less than half) of the range of motion.
- 2: More marked increase in tone throughout most of the range of motion, but the joint moves easily.
- 3: Considerable increase in muscle tone; passive movement is difficult.
- 4: The affected part is rigid in both flexion and extension.
Practicalactical Recommendations
The modified Ashworth scale should be used with caution and consideration. It is important to perform the examination in a controlled environment to minimize external factors that may affect the interpretation of muscle tone. During the evaluation, it is recommended:
- Perform the passive movement slowly and evenly.
- Maintain a fixed posture during the exam.
- Evaluate both flexion and extension of the joint.
The results obtained with this scale can be used to monitor changes in muscle tone over time and to evaluate the effectiveness of the treatments implemented. It is important to remember that spasticity is a complex aspect of cerebral palsy disorder (CPDD) and its evaluation should be considered along with other clinical criteria.