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Grading Muscle Spasticity With a Modified Ashworth Scale

Description

Spasticity is a velocity-dependent response which may be shown by skeletal muscle during passive stretching. It is a finding which may be seen in central nervous system disorders. The scale of Ashworth was modified by Bohannon and Smith to make it more discrete for grading mild disorders.


Physical Findings

Grade

no increase in muscle tone

0

slight increase in muscle tone, manifested by either a catch and release or a minimal resistance at the end of the range of motion when the affected body part is moved in flexion or extension

1

slight increase in muscle tone, with catch followed by minimal resistance, with the resistance affecting less than half of the range of motion

1+

more marked increase in muscle tone over most of the range of motion; the affected body part can still be easily moved

2

considerable increase in muscle tone, making passive movement difficult

3

affected body part rigid in flexion or extension

4

 

where:

• Grade 1+ was added by Bohannon and Smith, who also expanded on the description of the physical findings.

 

Implementation:

• I will grade flexion and extension separately, then record the maximum grade.


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