Inter-rater reliability of the Modified Modified Ashworth Scale in assessing lower limb muscle spasticity

Primary objective: To assess the inter-rater reliability of the Modified Modified Ashworth Scale (MMAS) in lower limb muscle spasticity. Research design: Cross-sectional observational study. Interventions: Not applicable. Methods and procedures: Twenty-two adults with neurological conditions (17 women, five men, age range 21-82 years; mean +/- SD, 44 +/- 18 years) participated. Hip adductor, knee extensor and ankle plantarflexor were assessed in a random order. Main outcomes and results: Inter-rater agreement for two raters was very good for the hip adductor and the knee extensor (weighted kappa = 0.82, p 0.0001) and good for the ankle plantarflexor (weighted kappa = 0.74, p 0.0001). Conclusions: The Modified Modified Ashworth Scale produced reliable measurements between raters in the assessment of lower limb muscle spasticity.