In this article, we will discuss the Modified Ashworth Scale. So, let’s get started.
Modified Ashworth Scale
Modified Ashworth Scale is used as a simple measure of Spasticity (muscle tone).
0 – No increase in muscle tone
1 – Slight increase in muscle tone, manifested by a catch or by minimal resistance at the end range of motion when the affected part moves in flexion or extension.
1+ – Slight increase in muscle tone, manifested by a catch, followed by minimal resistance throughout the remainder range of motion.
2 – More marked increase in muscle tone through most of the range of motion, but the affected part/parts easily moved.
3 – Considerable increase in muscle tone, passive movement becomes difficult
4 – Affected part/parts rigid in flexion or extension.
The point score is calculated from a patient’s age and 12 routine physiological measures :
AaDO2 or PaO2
Rectal Temperature
Mean arterial pressure
Arterial pH
Heart rate
Respiratory rate
Serum Sodium
Serum Potassium
Creatinine
Hematocrit
White blood cell count
GCS (Glasgow Coma Scale)
(2) Chedoke – Mcmaster Stroke Assessment
It is a screening and assessment tool utilized to measure physical impairment and activity of an individual following a stroke. The CMSA consists of two inventories. First is the Impairment Inventory, which assesses 6 domains shoulder pain and stages of recovery of postural control, arm, hand, leg and foot. Each domain is scored on a 7-point scale from Stage 1 till Stage 7, most impairment to no impairment, respectively. Second is the Activity Inventory , which assesses gross motor function includes 10 items evaluating rolling, sitting, transferring and standing and walking includes.
The 15 items are scored on a 7-point scale from 1 till 7 , from complete dependence to independent, respectively.
(3) Glasgow Coma Scale
(4) Roye Score
The Roye Score is a 10-item disease-specific instrument to measure outcomes of treatment for CTEV (clubfoot)
(5) VISA-A Scale
The VISA-A aims at the evaluation of the clinical severity for patients with chronic Achilles tendinopathy. It is an easily self administered questionnaire that evaluates symptoms and their effect on physical activity.
(6) Fugl Meyer Stroke Assessment
The Fugl Meyer Assessment is a stroke specific, performance based impairment index. It is designed to assess motor functioning, balance, sensation and joint functioning in patients with post stroke hemiplegia. It is applied clinically and in research to evaluate disease severity, describe motor recovery, and to plan and assess treatment.
The scale is comprised of five domains :
Motor functioning of the upper and lower extremities
Sensory functioning evaluates light touch on two surfaces of the arm and leg, and position sense for 8 joints
Balance contains 7 tests, 3 seated and 4 standing
Joint range of motion for 8 joints
Joint pain
The motor domain includes items assessing movement, coordination, and reflex action of the shoulder, elbow, forearm, wrist, hand, hip, knee, and ankle.
Scoring is based on direct observation of performance.
Scale items are scored on the basis of ability to complete the item using a 3 point ordinal scale
where 0=cannot perform, 1=performs partially and 2=performs fully. The total possible scale score is 226
Motor score: ranges from 0 means hemiplegia to 100 points means normal motor activity .
Sensation: ranges from 0 to 24 points.
Balance: ranges from 0 to 14 points.
Joint range of motion: ranges from 0 to 44 points.
Joint pain: ranges from 0 to 44 points.
(7) Houghton Scale
The Houghton scale is a 4 item instrument that accesses prosthetic use in people underwent lower extremity or lower limb amputations. It is a self administered and easy to score.
(8) McGill Pain Questionnaire
The McGill Pain Questionnaire is a self reporting measure of pain used for patients with a number of diagnosis. It assesses both quality and intensity of subjective pain.
(9) WHO Development Milestones
WHO scale aims to link the growth of the child and the motor development in a single category
WHO provides an important information about child’s gross motor development in different cultural settings
The WHO milestone assessment consist of six items which were selected because they have been considered to be universal, fundamental, and simple to test and evaluate.
The six items on the WHO milestone scale are mentioned below:
Sitting without support
Hands and knees crawling
Standing with assistance
Walking with assistance
Standing alone
Walking alone
(10) Revised Hammersmith Scale
The Revised Hammersmith Scale is specifically design outcome measure for people affected by Spinal Muscular Atrophy
The scale consist of 33 items with grades of 0,1 and 2. For individuals who can achieve the task without any obstacle is given a score of 2. For those who only attempt the movement or finish it with some form of hindrance or compensation is scored 1 and score of 0 is given when patients are unable to perform any part of the task.
(11) Visual Analogue Scale
The Visual Analogue Scale is a psychometric response scale, it is a measurement instrument for subjective characteristics or attitudes that cannot be directly measured. It is a tool used to help a person rate the intensity of pain. The visual analog scale for pain is a straight line with one end meaning no pain and the other end meaning the worst pain imaginable. A patient marks a point on the line that matches the amount of pain he or she feels
(12) Balance Outcome Measure For Elderly Rehabilitation
The Balance Outcome Measure for Elder Rehabilitation (BOOMER) was developed for assistance in clinical practice to quantify standing balance.
The combination of a variety of commonly used, single item outcome measures makes the BOOMER a more practical tool that is highly efficient.
(13) Chronic Pain Grade Scale
The CPGS is a two dimensional measure that evaluates 2 dimensions of overall chronic pain severity:
pain intensity
pain-related disability.
It is suitable for use in all chronic pain conditions, including chronic musculoskeletal and low back pain.
(14) Disabilities of the Arm Shoulder and Hand
The DASH questionnaire is a 30 item questionnaire that looks at the ability of a patient to perform certain upper extremity activities. This questionnaire is a self reported questionnaire that patients can rate difficulty and interference with daily life on a 5 point Likert scale
DASH Scoring Formula = {[(sum of n responses)/n] -1} (25) where n represents the number of completed items
(15) Fatigue Severity Scale
It is a 9 item scale which measures the severity of fatigue and its effect on a person’s activities and lifestyle in patients with a variety range of disorders
The items are scored on a 7 point scale
1= strong disagree
7= strong agree
The minimum score is 9 and maximum score possible is 63. Higher the score greater the severity of fatigue
(16) Elderly Mobility Scale
To measure the function of frail elderly adults.
The Elderly Mobility Scale was developed in 1994 as part of an assessment package. It is a relatively simple outcome measure and is quick administration or quick performed
(17) The Foot and Ankle Ability Measure
Foot and Ankle Ability Measure is a self reported outcome instrument developed to evaluate physical function for individuals with foot and ankle related impairments.
The Foot and Ankle Ability Measure is a 29 item questionnaire divided into two subscales:
The Foot and Ankle Ability Measure, 21 item Activities of Daily Living Subscale
The Foot and Ankle Ability Measure, 8 item Sports Subscale
(18) Tinneti Falls Efficacy Scale
The Tinetti Falls Efficacy Scale is used to evaluate and assess perception of balance and stability during activities of daily living and fear of falling in the elderly people, along with those diagnosed with Multiple Sclerosis.
(19) Foot Function Index
Foot Function Index was developed in 1991 to measure the impact of foot pathology on function in terms of pain, disability and activity limitation. It is a self administered index consisting of 23 items divided into 3 sub scales or categories.
(20) Constant-Murley Score
The Constant-Murley score is a 100 points scale composed of a number of individual parameters. These parameters define the level of pain and the ability to carry out the normal daily activities of the patient.The Constant-Murley score was introduced to determine the functionality after the treatment of a shoulder injury or trauma. The test is divided into four subscales
Pain featuring 15 points
Activities of daily living featuring 20 points
Strength featuring 25 points
Range of motion includes forward elevation, external rotation, abduction and internal rotation of the shoulder featuring 40 points.
The higher the score, the higher the quality of the function
