The Modified Tardieu Scale for the measurement of elbow flexor spasticity in adult patients with hemiplegia

Primary objective: To investigate the inter-rater reliability of the Modified Tardieu Scale (MTS) in the measurement of elbow flexor muscle spasticity in patients with adult hemiplegia. Research design: A cross-sectional study to examine the agreement between two raters on elbow flexor muscle spasticity using Modified Tardieu Scale. Interventions: Not applicable. Methods and procedures: Thirty patients (21 men, nine women) with an age range of 21-79 years (mean = 54.9; SD = 15.7) were tested. Two inexperienced raters assessed the elbow flexor muscle spasticity in the affected side during the same session. The order of assessments by the two raters was randomized. The main outcome measure was dynamic component of spasticity (R2-R1). Reliability was also calculated for MTS scores, angle of muscle reaction (R1), and passive range of motion (R2). Main outcomes and results: The ICC for R2-R1 was 0.72. The ICC for MTS scores, R1 and R2 were 0.74, 0.74 and 0.56, respectively. Conclusions: The Modified Tardieu Scale did not provide acceptable high inter-rater reliability in the measurement of muscle spasticity in patients with hemiplegia when used by raters of limited experience.