1、目录 Modified Ashworth Scale 2 Purpose of the measure 2 Available versions 2 Features of the measure . 3 Alternative forms of the Modified Ashworth Scale . 7 Client suitability . 8 Modified Tardieu Scale (MTS) . 10 Purpose of the measure 10 Available versions 11 Features of the measure . 12 Scoring an
2、d Score Interpretation 15 Alternative forms of the Modified Tardieu Scale 17 Client suitability . 19 Modified Ashworth Scale Purpose of the measure The Modified Ashworth Scale is considered the primary clinical measure of muscle spasticity in patients with neurological conditions. However, some publ
3、ications question its ability to measure spasticity and advocate the Modified Ashworth Scale as a rating scale to measure abnormality in tone or the resistance to passive movements, since there is no clinically direct method for measuring spasticity (Gregson, Leathley, Moore, Sharma, Smith Pandyan,
4、Johnson, Price, Curless, Barnes Pandyan, Johnson, Price, Curless, Barnes and R2 (passive range of motion following a slow velocity stretch - V1) (Mackey, Watt, Lobb Morris 2002). Other joints, in particular the neck, must also remain in a constant position for the duration of the test and on subsequ
5、ent testing. 痉挛评估分级应在每天同一时刻进行 ，并且 重复测量时 被测肢体要摆在相同的位置 。 TMS 为保持结果的一致性，也定义了肢体的摆放位置 (Boy Morris 2002)。其他关节，尤其是颈部 ，务必在整个检查以及后续检查中保持在同一位置。 Angle of muscle reaction (Y): Measured relative to the position of minimal stretch of the muscle (corresponding to angle) for all joints except hip, where is it relat
6、ive to the resting anatomical position (Gracies, Marosszeky, Renton, Sandanam, Gandevia Singh et al., 2011) 培训要求： 未见特定报道，但测量者的经验势必会影响结果 (Ansari et al., 2008; Singh et al., 2011)。 Subscales None. 子量表：无 Equipment: Pencil or pen Goniometer Mat, plinth or bed 器材：铅笔或圆珠笔；量角器；治疗垫、辅具或床。 Alternative forms of
7、 the Modified Tardieu Scale Tardieu Scale: First developed in 1954, the Tardieu Scale has been suggested as a reliable alternative to the Ashworth Scales, as it compares the muscles resistance to passive stretch at both slow and fast speeds in order to account for the velocity-dependent characterist
8、ic of spasticity. 改良 Tardieu 量表的其他形式 Tardieu 量表： 1954 年首现， Tardieu 量表曾被认为可作为 Ashworth 量表 替代选择，因为它 考虑到痉挛速度依赖性的特点， 对比了 慢速和快速 被动牵伸时 肌肉阻力的情况， Modified Tardieu Scale: Published in 1999, the MTS uses the same grading scale outlined in the original Tardieu Scale, however the modifications aim to standardiz
9、e the testing procedure. Specific limb placement, alignment positions and procedures are described. Measures of passive range of motion are described as R2; the angle of muscle reaction (catch) is described as R1; and the difference between the two measures (R2-R1) are used to help differentiate spa
10、sticity and soft-tissue restrictions (Boyd and Graham, 1999). 改良 Tardieu 量表： 1999 年发表， MTS 使用同原版 Tardieu 量表相同的 评分量表，但改良的目的在于规范化检查流程。特定的肢体摆放、 对线以及流程都有所描述。测量被动关节活动范围时，描述见 R2；测量肌肉反射（出现 “ 卡住”）时，描述见 R1；两次测量（ R2-R1）的差异可以用来辅助鉴别痉挛和软组织限 制（ (Boyd and Graham, 1999)。 Score definitions for the Tardieu Scale and
11、the MTS are provided below. Score definitions between the two measures are consistent. Tardieu 量表和 MTS 的分数定义见下。 两种测量方式的分数定义是一致的。 Quality of muscle reaction (X): 肌肉反应的品质性质（ X） Grade Description 描述 0 No resistance throughout the course of the passive movement. 整个被动活动中 无 阻力。 1 Slight resistance through
12、out the course of the passive movement, with no clear catch at a precise angle. 被动活动中感到轻微阻力，但 没有在 特定角度出现明显的卡住 感。 2 Clear catch at a precise angle, interrupting the passive movement, followed by a release. 特定角度出现明显卡住，被动运 动 受阻， 后会有释放感。 3 Fatigable clonus (10 seconds when maintaining pressure) occurrin
13、g at a precise angle. 特定角度出现 fatigable 的阵挛（ 持续给予压力时 远 大 于 10s） 5 Joint is immoveable. 关节 僵直，不可动。 Client suitability Can be used with: Clients with stroke. Clients with other neurological impairment such as cerebral palsy (Boyd & Graham, 1999) and traumatic brain injury (Mehrholz et al., 2005). Should not be used in: To date, there is no information on restrictions for using the Tardieu Scale or the MTS. 临床适应症： 可以用于：脑卒中、其他神经系统障碍如脑瘫 (Boyd & Graham, 1999)、脑外伤(Mehrholz et al., 2005)。 禁忌：目前为止尚无关于使用 Tardieu 量比或 MTS 受限 的信息。
