Modified Ashworth Scale

Question 1

What is the Modified Ashworth Scale used for?

Answer 1

This is a qualitative scale for grading spasticity

• amount of resistance to passive stretch
• The Modified Ashworth Scale is used to measure spasticity in patients with upper motor neuron lesions.

Question 2

Grade 0

Answer 2

No increase in muscle tone

Question 3

Grade 1

Answer 3

Slight increase in muscle tone, manifested by a catch and release or by minimal resistance at the end range of motion

• when the affected part(s) are moved in flexion or extension

Question 4

Grade 1+

Answer 4

Slight increase in muscle tone, manifested by a catch, followed by minimal resistance throughout the remainder of the ROM

(LESS THAN HALF)

Question 5

Grade 2

Answer 5

“Marked” increase in muscle tone through most of the ROM

(GREATER THAN HALF)

Affected part still moved easily

Question 6

Grade 3

Answer 6

Considerable increase in muscle tone, passive movement difficult

Question 7

Grade 4

Answer 7

Affected part(s) rigid in flexion or extension

(immoveable)

Question 8

What is the correct technique to assess the spasticity of the hip extensors?

move the test leg from maximal flexion to extension quickly
move the test leg from maximal flexion to extension slowly
move the test leg from maximal extension to flexion quickly
move the test leg from maximal extension to flexion slowly

Answer 8

Correct Answer: move the test leg from maximal extension to flexion quickly

To test a muscle that primarily extends a joint, the joint should be placed in maximal extension and moved it into maximal flexion. The test should be performed quickly (i.e., 1 second) since spasticity is velocity dependent.

Question 9

What is the best time to assess spasticity for a patient with multiple sclerosis?

before the patient takes their anti-spasticity medication
after the patient takes their anti-spasticity medication
before and after the patient takes their anti-spasticity medication
spasticity is not typically a symptom of multiple sclerosis

Answer 9

Correct Answer: before and after the patient takes their anti-spasticity medication

Multiple sclerosis produces patches of demyelination of the myelin sheaths that surround nerves within the brain and spinal cord. This decreases the efficiency of nerve impulse transmission and symptoms will vary based on the location and the extent of demyelination. The original purpose of the Modified Ashworth Scale was to assess the effectiveness of anti-spasticity medication in patients with multiple sclerosis. It is important to assess the patient when on and off spasticity medication in order to effectively improve function under both conditions

Question 10

When testing a muscle, how fast should the joint be moved through its range of motion?

Answer 10

One Second