Responsiveness and minimal clinically important difference of Modified Ashworth Scale in patients with stroke
| Autor: | I-Hsuan Shen, Chung-Yao Chen, Chia-Ling Chen, Ching-yi Wu, Hsieh-Ching Chen, Yu-wei Hsieh, Keh-chung Lin |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
musculoskeletal diseases
Adult Male 030506 rehabilitation medicine.medical_specialty medicine.medical_treatment Modified Ashworth scale Population Minimal Clinically Important Difference Physical Therapy Sports Therapy and Rehabilitation 03 medical and health sciences Muscle tone Young Adult 0302 clinical medicine Physical medicine and rehabilitation Activities of Daily Living Medicine Humans Spasticity Longitudinal Studies education Stroke Aged education.field_of_study Rehabilitation business.industry Minimal clinically important difference Middle Aged medicine.disease body regions medicine.anatomical_structure Muscle Spasticity Muscle Tonus Quality of Life Female Ankle medicine.symptom 0305 other medical science business 030217 neurology & neurosurgery Follow-Up Studies |
| Zdroj: | European journal of physical and rehabilitation medicine. 55(6) |
| ISSN: | 1973-9095 |
| Popis: | Background Spasticity is a major problem in patients with stroke and influences their activities of daily living, participation, and quality of life. The Modified Ashworth Scale is widely used to assess spasticity. However, the responsiveness and minimal clinically important differences of the Modified Ashworth Scale in patients with stroke have not been explored. Aim This study aims to examine the responsiveness and minimal clinically important differences of the Modified Ashworth Scale in patients with stroke. Design Longitudinal six-month follow-up study. Setting Rehabilitation wards of a tertiary hospital. Population One-hundred and fifteen patients with stroke were recruited. Methods All patients underwent the assessment of Modified Ashworth Scale for the upper extremity (flexors of the elbow, wrist, and fingers) and the lower extremity (hip adductor, knee flexor, and ankle plantar flexor) at baseline and 6-month follow-up. The average Modified Ashworth Scale scores of the upper and lower extremity muscles were obtained for analysis. Responsiveness of the Modified Ashworth Scale was determined using standardized mean response, and the minimal clinically important differences were determined using a distribution-based approach with Effect Sizes of 0.5 and 0.8 standard deviations. Results The responsiveness of the Modified Ashworth Scale in the upper and lower extremity muscles was marked (standardized response mean = 0.89-1.09). The minimal clinically important differences of the average Modified Ashworth Scale of Effect Sizes 0.5 and 0.8 standard deviations for the upper extremity muscles were 0.48 and 0.76, respectively, while those for the lower extremity muscles were 0.45 and 0.73, respectively. Conclusions The Modified Ashworth Scale was markedly responsive in detecting the changes in muscle tone in patients with stroke. The minimal clinically important differences of the Modified Ashworth Scale reported in this study can be used by researchers and clinicians in determining whether the observed changes are clinically meaningful post-treatment or at follow-up. Clinical rehabilitation impact The minimal clinically important differences of the Modified Ashworth Scale reported in this study will enable clinicians and researchers in determining whether changes in the muscle tone are true and clinically meaningful, and can be used as a reference for clinical decision-making. |
| Databáze: | OpenAIRE |
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