Clinical scales for the assessment of spasticity, associated phenomena, and function: a systematic review of the literature

References from the systematic review

• Albright AL, Cervi A, Singletary J. Intrathecal Baclofen for Spasticity in Cerebral-Palsy. Journal of the American Medical Association 1991;265:1418-1422.
   Google Scholar
• Allington NJ, Leroy N, Doneux C. Ankle joint range of motion measurements in spastic cerebral palsy children: intraobserver and interobserver reliability and reproduci- bility of goniometry and visual estimation. Journal of Pediatric Orthopaedics. Part B/European Paediatric Ortho- paedic Society, Pediatric Orthopaedic Society of North America 2002;11:236-239.
   Google Scholar
• Bakheit AMO, Thilmann AF, Ward AB et al. A rando- mized, double-blind, placebo-controlled, dose-ranging study to compare the efficacy and safety of three doses of botulinum toxin type A (Dysport) with placebo in upper limb spasticity after stroke. Stroke 2000;31:2402-2406.
   Google Scholar
• Bakheit AMO, Pittock S, Moore AP et al. A randomized, double-blind, placebo-controlled study of the efficacy and safety of botulinum toxin type A in upper limb spasticity in patients with stroke. European Journal of Neurology 2001;8:559-565.
   Google Scholar
• Bakheit AMO, Maynard VA, Curnow J, Hudson N, Kodapala S. The relation between Ashworth scale scores and the excitability of the a motor neurones in patients with post-stroke muscle spasticity. Journal of Neurology, Neu- rosurgery and Psychiatry 2003;74:646-648.
   Google Scholar
• Barnes S, Gregson J, Leathley M, Smith T, Sharma A, Watkins C. Development and inter-rater reliability of an assessment tool for measuring muscle tone in people with hemiplegia after a stroke. Physiotherapy, 85(8):405-409, 1999 Aug. (13 Ref) 1999;405-409.
   Google Scholar
• Barwood SA, Baillieu CE, Keer G. Validity of a clinical measure of spasticity in childtren with cerebral palsy in a randomized clinical trail. AACPDM Abstracts 1998, B:2
   Google Scholar
• Berardelli A, Sabra AF, Hallett M, Berenberg W, Simon SR. Strech reflexes of triceps surae in patients with upper motor neuron syndromes. Journal of Neurology, Neursur- gery, and Psychiatry 1983;46:54-60.
   Google Scholar
• Bertoti DB. Effect of short leg casting on ambulation in children with cerebral palsy. Physical Therapy 1986;66: 1522-1529.
   Google Scholar
• Bhakta BB, Cozens JA, Chamberlain MA, Bamford JM. Impact of botulinum toxin type A on disability and carer burden due to arm spasticity after stroke: a randomised double blind placebo controlled trial. Journal of Neurology, Neurosurgery and Psychiatry 2000;69:217-221.
   Google Scholar
• Bhakta BB, Cozens JA, Chamberlain MA, Bamford JM. Quantifying associated reactions in the paretic arm in stroke and their relationship to spasticity. Clinical Rehabilitation 2001;15:195-206.
   Google Scholar
• Blackburn M, van Vliet P, Mockett SP. Reliability of measurements obtained with the Modified Ashworth Scale in the lower extremities of people with stroke. Physical Therapy 2002;82:25-34.
   Google Scholar
• Bodin PG, Morris ME. Interrater reliability of the Modified Ashworth Scale for wrist flexor spasticity following stroke. World Federation of Physiotherapy, 11th Congress; 1991. p 505-507.
   Google Scholar
• Bohannon RW, Larkin PA, Smith MB, Horton MG. Relationship between static muscle strength deficits and spasticity in stroke patients with hemiparesis. Physical Therapy 1987;67:1068-1071.
   Google Scholar
• Bohannon RW, Smith MB. Interrater reliability of a modified Ashworth scale of muscle spasticity. Physical Therapy 1987;67:206-207.
   Google Scholar
• Bohannon RW, Warren ME, Cogman KA. Motor variables correlated with the hand-to-mouth maneuver in stroke patients. Archives of Physical Medicine and Rehabilitation 1991;72:682-684.
   Google Scholar
• Boissy P, Bourbonnais D, Kaegi C, Gravel D, Arsenault BA. Characterization of global synkineses during hand grip in hemiparetic patients. Archives of Physical Medicine and Rehabilitation 1997;78:1117-1124.
   Google Scholar
• Brar SP, Smith MB, Nelson LM, Franklin GM, Cobbe ND. Evaluation of treatment protocols on minimal to moderate spasticity in multiple sclerosis. Archives of Physical Medicine and Rehabilitation 1991;72:186-189.
   Google Scholar
• Brashear A, Zafonte R, Corcoran M, Galvez-Jimenez N, Gracies J-M, Forrest Gordon M, Mcafee A, Ruffing K, Thompson B, Williams M, Lee C-H, Turkel C. Inter- and intrarater reliability of the Ashworth Scale and the diability assessment scale in patients with upper-limb poststroke spasticity. Archives of Physical Medicine and Rehabilitation 2002;83:1349-1354.
   Google Scholar
• Burbaud P, Wiart L, Dubos JL et al. A randomised, doubleblind, placebo controlled trial of botulinum toxin in the treatment of spastic foot in hemiparetic patients. Journal of Neurology, Neurosurgery and Psychiatry 1996;61:265-269.
   Google Scholar
• Casale R, Glynn CJ, Buonocore M. Reduction of spastic hypertonia in patients with spinal cord injury: a double- blind comparison of intravenous orphenadrine citrate and placebo. Archives of Physical Medicine and Rehabilitation 1995;76:660-665.
   Google Scholar
• Cutter NC, Scott DD, Johnson JC, Whiteneck G. Gabapentin effect on spasticity in multiple sclerosis: a placebo-controlled, randomized trial. Archives of Physical Medicine and Rehabilitation 2000;81:164-169.
   Google Scholar
• Damiano DL, Quinlivan JM, Owen BF, Payne P, Nelson KC, Abel MF. What does the Ashworth scale really measure and are instrumented measures more valid and precise? Developmental Medicine and Child Neurology 2002;44:112-118.
   Google Scholar
• Drory VE, Goltsman E, Goldman Reznik J, Mosek A, Korczyn AD. The value of muscle exercise in patients with amyotrophic lateral sclerosis. Journal of Neurological Sciences 2001;191:133-137.
   Google Scholar
• Emre M, Leslie GC, Muir C, Part NJ, Pokorny R, Roberts RC. Correlations Between Dose, Plasma-Concentrations, and Antispastic Action of Tizanidine (Sirdalud(R)). Journal of Neurology, Neurosurgery and Psychiatry 1994;57:1355-1359.
   Google Scholar
• Eng JJ, Chu KS, Dawson Ashworth scales, Kim CM, Hepburn KE. Functional walk tests in individuals with stroke-Relation to perceived exertion and myocardial exertion. Stroke 2002;33:756-761.
   Google Scholar
• Fehlings D, Rang M, Glazier J, Steele C. An evaluation of botulinum-A toxin injections to improve upper extremity function in children with hemiplegic cerebral palsy. Journal of Pediatrics 2000;137:331-337.
   Google Scholar
• Femery V, Moretto P, Renaut H, Thevenon A. [Spasticity and dynamic plantar pressure distribution measurements in hemiplegic spastic children] [French]. Annales de Read- aptation et de Medecine Physique 2001; 44(1):26-34.
   Google Scholar
• Flett PJ, Stern LM, Waddy H, Connell TM, Seeger JD, Gibson SK. Botulinum toxin A versus fixed cast stretching for dynamic calf tightness in cerebral palsy. Journal of Paediatrics and Child Health 1999;35:71-77.
   Google Scholar
• Fosang AL, Galba MP, Reddihough D, McCoy A. The inter- and intarater reliability of three clinial measures in the lower limb for children with cerebral palsy. Australian Journal of Physiotherapy 2002;48:141.
   Google Scholar
• Fowler EG, Nwigwe AI, Ho TW. Sensitivity of the pendulum test for assessing spasticity in persons with cerebral palsy. Developmental Medicine and Child Neurol- ogy 2000;42:182-189.
   Google Scholar
• Gilmartin R, Bruce D, Storrs BB et al. Intrathecal baclofen for management of spastic cerebral palsy: Multicenter trial. Journal of Child Neurology 2000;15:71-77.
   Google Scholar
• Ghosh D, Pradhan S. ‘Extensor toe sign’ by various Methods in spastic children with cerebral palsy. Journal of Child Neurology 1998;13:216-220.
   Google Scholar
• Goulet C, Arsenault AB, Bourbonnais D, Larame´e M-T, Lepage Y. Effects of transcutaneous electrical nerve stimulatio on H-reflex and spinal spasticity. Scandinavian Journal of Rehabilitation and Medicine 1996;28:169-176.
   Google Scholar
• Gregson JM, Leathley MJ, Moore AP, Smith TL, Sharma AK, Watkins CL. Reliability of measurements of muscle tone and muscle power in stroke patients. Age and Ageing 2000;29:223-228.
   Google Scholar
• Gregson JM, Leathley M, Moore AP, Sharma AK, Smith TL, Watkins CL. Reliability of the Tone Assessment Scale and the modified Ashworth scale as clinical tools for assessing poststroke spasticity. Archives of Physical Medi- cine and Rehabilitation 1999;80:1013-1016.
   Google Scholar
• Gruenthal M, Mueller M, Olson WL, Priebe MM, Sher- wood AM, Olson WH. Gabapentin for the treatment of spasticity in patients with spinal cord injury. Spinal Cord 1997;35:686-689.
   Google Scholar
• Haas BM, Bergstrom E, Jamous A, Bennie A. The inter rater reliability of the original and of the modified Ashworth scale for the assessment of spasticity in patients with spinal cord injury. Spinal Cord 1996;34:560-564.
   Google Scholar
• Hesse S, Reiter F, Konrad M, Jahnke MT. Botulinum toxin type A and short-term electrical stimulation in the treatment of upper limb flexor spasticity after stroke: a randomized, double-blind, placebo-controlled trial. Clinical Rehabilita- tion 1998;12:381-388.
   Google Scholar
• Hsu AL, Tang PF, Jan MH. Analysis of Impairments Influencing Gait Velocity and Asymmetry of Hemiplegic Patients after Mild to Moderate Stroke. Archives of Physical Medicine and Rehabilitation 2003; 8(84):1185-1193.
   Google Scholar
• Hyman N, Barnes M, Bhakta B et al. Botulinum toxin (Dysport) treatment of hip adductor spasticity in multiple sclerosis: a prospective, randomised, double blind, placebo controlled, dose ranging study [see comments]. Journal of Neurology, Neurosurgery and Psychiatry 2000;68:707-712.
   Google Scholar
• Katz RT, Rovai GP, Brait C, Rymer WZ. Objective Quantification of Spastic Hypertonia-Correlation with Clinical Findings. Archives of Physical Medicine and Rehabilitation 1992;73:339-347.
   Google Scholar
• Kirazli Y, On AY, Kismali B, Aksit R. Comparison of phenol block and botulinus toxin type A in the treatment of spastic foot after stroke. American Journal of Physical Medicine and Rehabilitation 1998;77:510-515.
   Google Scholar
• Lee A, Patterson V. A double-blind study of L-threonine in patients with spinal spasticity. Acta Neurologica Scandina- vica 1993;88:334-338.
   Google Scholar
• Leonard CT, Stephens JU, Stroppel SL. Assessing the spastic condition of individuals with upper motoneuron involvement: Validity of the myotonometer. Archives of Physical Medicine and Rehabilitation 2001;82:1416-1420.
   Google Scholar
• Levin MF, Hui-Chan. Are H and strectch reflexes in hemiparesis reproducible and correlated with spasticity? Journal of Neurology 1993;240:63-71.
   Google Scholar
• Lin FM, Sabbahi M. Correlation of spasticity with hyperactive stretch reflexes and motor dysfunction in hemiplegia. Archives of Physical Medicine and Rehabilita- tion 1999;80:526-530.
   Google Scholar
• Litvan I, Mangone CA, Werden W et al. Reliability of the NINDS Myotatic Reflex Scale. Neurology 1996;47:969-972.
   Google Scholar
• Loubser PG, Narayan RK, Sandin KJ, Donovan WH, Russell KD. Continuous infusion of intrathecal baclofen: long-term effects on spasticity in spinal cord injury. Paraplegia 1991;29:48-64.
   Google Scholar
• Love SC, Valentine JP, Blair EM, Price CJ, Cole JH, Chauvel PJ. The effect of botulinum toxin type A on the functional ability of the child with spastic hemiplegia a randomized controlled trial. European Journal of Neurology 2001;8:50-58.
   Google Scholar
• Malouin F, Bonneau C, Pichard L, Corriveau D. Non- reflex mediated changes in plantarflexor muscles early after stroke. Scandinavian Journal of Rehabilitation and Medi- cine 1997;29:147-153.
   Google Scholar
• Marque P, Simonetta-Moreau M, Maupas E, Roques CF. Facilitation of transmission in heteronymous group II pathways in spastic hemiplegic patients. Journal of Neurol- ogy, Neurosurgery and Psychiatry 2001;70:36-42.
   Google Scholar
• Maruishi M, Mano Y, Sasaki T, Shinmyo N, Sato H, Ogawa T. Cerebral palsy in adults: Independent effects of muscle strength and muscle tone. Archives of Physical Medicine and Rehabilitation 2001;82:637-641.
   Google Scholar
• Maurer M, Henn V, Dittrich A, Hofmann A. Delta-9- tetrahydrocannabinol shows antispastic and analgesic effects in a single case double-blind trial. European Archives of Psychiatry and Clinical Neuroscience 1990; 240(1):1-4.
   Google Scholar
• Mayo NE, Sullivan SJ, Swaine B. Observer Variation in Assessing Neurophysical Signs Among Patients with Head- Injuries. American Journal of Physical Medicine and Rehabilitation 1991;70:118-123.
   Google Scholar
• McCrea PH, Eng JJ, Hodgson AJ. Linear spring-damper model of the hypertonic elbow: reliability and validity. Journal of Neuroscience Methods 2003;128:121-128.
   Google Scholar
• McDowell BC, Hewitt V, Nurse A, Weston T, Baker R. The variability of goniometric measurements in ambulatory children with spastic cerebral palsy. Gait and Posture 2000;12:114-121.
   Google Scholar
• Medaer R, Hellebuyk H, Van den Brande E, Saxena V, Lthijs M, Kovacs L, Eerdekens M, Dehaen F. Treatment of Spasticity due to stroke: A double-blind, cross-over trial comparing baclofen with placebo. Acta Therapeutica 1991;17:323-331.
   Google Scholar
• Meythaler JM, Guin-Renfroe S, Johnson A, Brunner RM. Prospective assessment of tizanidine for spasticity due to acquired brain injury. Archives of Physical Medicine and Rehabilitation 2001;82:1155-1163.
   Google Scholar
• Milanov I. Clinical and neurophysiological correlations of spasticity. Functional Neurology 1999;14:193-201.
   Google Scholar
• Milanov I. Examination of the segmental pathophysiological mechanisms of spasticity. Electromyogr. Clinical Neuro- physiology 1994;34:73-79.
   Google Scholar
• Milanov IG. A comparison of methods to assess the excitability of lower motoneurones. Canadian Journal of Neurological Science 1992;19:64-68.
   Google Scholar
• Milla PJ, Jackson AD. A controlled trial of baclofen in children with cerebral palsy. Journal of International Medical Research 1977;5:398-404.
   Google Scholar
• Mngoma NF, Culham EG, Bagg SD. Resistance to passive shoulder external rotation in persons with hemiplegia: Evaluation of an assessment system. Archives of Physical Medicine and Rehabilitation 1999;80:531-535.
   Google Scholar
• Moon SK et al. Antispastic effect of electroacupuncture and moxibustion in stroke patients. American Journal of Chinese Medicine 2003; 31(3):467-474.
   Google Scholar
• Mueller ME, Gruenthal M, Olson WL, Olson WH. Gabapentin for relief of upper motor neuron symptoms in multiple sclerosis. Archives of Physical Medicine and Rehabilitation 1997;78:521-524.
   Google Scholar
• Nance PW, Bugaresti J, Shellenberger K et al. Efficacy and Safety of Tizanidine in the Treatment of Spasticity in Patients with Spinal-Cord Injury. Neurology 1994;44:44-52.
   Google Scholar
• Nance PW, Sheremata WA, Lynch SG et al. Relationship of the antispasticity effect of tizanidine to plasma concentra- tion in patients with multiple sclerosis. Archives of Neurology 1997;54:731-736.
   Google Scholar
• Nielsen JF, Sinkjaer T. A comparison of clinical and laboratory measures of spasticity. Multiple Sclerosis 1996;1:296-301.
   Google Scholar
• Nordmark E, Andersson G. Wartenberg pendulum test: objective quantification of muscle tone in children with spastic diplegia undergoing selective dorsal rhizotomy. Developmental Medicine and Child Neurology 2002;44:26-33.
   Google Scholar
• Nuyens GE, De Weerdt WJ, Ketelaer P, Feys H, De Wolf L, Hantson L, Nieuwboer A, Spaepen, Carton H. Inter- rater reliability of the Ashworth scale in multiple sclerosis. Clinical Rehabilitation 1994;8:286-292.
   Google Scholar
• Olgiati R, Burgunder JM, Mumenthaler M. Increased energy cost of walking in multiple sclerosis: effect of spasticity, ataxia, and weakness. Archives of Physical Medicine and Rehabilitation 1988;69:846-849.
   Google Scholar
• Pandyan AD, Price CIM, Rodgers H, Barnes MP, Johnson GR. Biomechanical examination of a commonly used measure of spasticity. Clinical Biomechanics 2001;16:859-865.
   Google Scholar
• Pandyan AD, Price CIM, Barnes MP, Johnson GR. A biomechanical investigation into the validity of the modified Ashworth Scale as a measure of elbow spasticitiy. Clinical Rehabilitation 2003;17:290-294.
   Google Scholar
• Panizza M, Balbi P, Russo G, Nilsson J. H-reflex recovery curve and reciprocal inhibition of H-reflex of the upper limbs in patients with spasticity secondary to stroke. American Journal of Physical Medicine and Rehabilitation 1995;74:357-363.
   Google Scholar
• Pellkofer M, Paulig M. Comparative double-blind study of the effectiveness and tolerance of baclofen, tetrazepam and tizanidine in spastic movement disorders of the lower extremities. Medizinische Klinik 1989;84:5-8.
   Google Scholar
• Penn RD, Savoy SM, Corcos D et al. Intrathecal baclofen for severe spinal spasticity. New England Journal of Medicine 1989;320:1517-1521.
   Google Scholar
• Pisano F, Miscio G, Del Conte C, Pianca D, Candeloro E, Colombo R. Quantitative measures of spasticity in post- stroke patients. Clinical Neurophysiology 2000;111:1015-1022.
   Google Scholar
• Pittock SJ, Moore AP, Hardiman O, Ehler E, Kovac M, Bojakowski J, Khawaja I, Brozman M, Kanovsky P, Skorometz A, Slawek J, Reichel G, Stenner A, Timerbaeva S, Stelmasiak Z, Zifko UA, Bhakta B, Coxon E. A double- blind randomised placebo-controlled evaluation of three doses of Botulinum Toxin Type A (Dysport) in the treatment of spastic equinovarus deformity after stroke. Cerebrovascular Diseases 2003;15:289-300.
   Google Scholar
• Pomeroy VM, Dean D, Sykes L et al. The unreliability of clinical measures of muscle tone: implications for stroke therapy. Age and Ageing 2000;29:229-233. Ref ID: 2710.
   Google Scholar
• Priebe MM, Sherwood AM, Thornby JI, Kharas NF, Markowski J. Clinical assessment of spasticity in spinal cord injury: a multidimensional problem. Archives of Physical Medicine and Rehabilitation 1996;77:713-716.
   Google Scholar
• Quinn F, Kearney PJ. French angles: a simple aid to neurodevelopmental examination. Irish Medical Journal 1989;82:131-132.
   Google Scholar
• Reiter F, Danni M, Lagalla G, Ceravolo G, Provinciali L. Low-dose botulinum toxin with ankle taping for the treatment of spastic equinovarus foot after stroke. Archives of Physical Medicine and Rehabilitation 1998;79:532-535.
   Google Scholar
• Richardson D, Sheean G, Werring D et al. Evaluating the role of botulinum toxin in the management of focal hypertonia in adults. Journal of Neurology, Neurosurgery and Psychiatry 2000;69:499-506.
   Google Scholar
• Roques CF, Felez A, Marque P, Chatain M, Condouret J, Tuffery R. A motor scale for the hemiplegic patients’ motor function assessment. Annales de Readaptation et de Medecine Physique 1997;40:147-158.
   Google Scholar
• Sachais BA, Logue JN, Carey MS. Baclofen, a new antispastic drug. A controlled, multicenter trial in patients with multiple sclerosis. Archives of Neurology 1977;34:422-428.
   Google Scholar
• Shaw J, Bially J, Deurvorst N, Macfie C, Brouwer B. Clinical and physiological measures of tone in chronic stroke. Neurology Report, 23(1): 19-24, 1999 Mar. (26 ref) 1999;19-24.
   Google Scholar
• Sheremata WA, Nance P, Shellenberger K. Correlation of Ashworth score with automated Wartenberg pendulum measurement of quadriceps spasticity in multiple sclerosis. Annals of Neurology 1997;42:T286.
   Google Scholar
• Siev-Ner I, Gamus D, Lerner-Geva L, Achiron A. Reflexology treatment relieves symptoms of multiple sclerosis: a randomised controlled study. Multiple Sclerosis 2003;9:356-361.
   Google Scholar
• Simpson DM, Alexander DN, Obrien CF et al. Botulinum toxin type A in the treatment of upper extremity spasticity: A randomized, double-blind, placebo-controlled trial. Neurology 1996;46:1306-1310.
   Google Scholar
• Skold C, Harms-Ringdahl K, Hultling C, Levi R, Seiger A. Simultaneous Ashworth measurements and electromyo- graphic recordings in tetraplegic patients. Archives of Physical Medicine and Rehabilitation 1998;79:959-965.
   Google Scholar
• Skold C, Levi R, Seiger A. Spasticity after traumatic spinal cord injury: Nature, severity, and location. Archives of Physical Medicine and Rehabilitation 1999;80:1548-1557.
   Google Scholar
• Skold C. Spasticity in spinal cord injury: Self- and clinically rated intrinsic fluctuations and intervention-induced changes. Archives of Physical Medicine and Rehabilitation 2000;81:144-149.
   Google Scholar
• Sloan RL, Sinclair E, Thompson J, Taylor S, Pentland B. Inter-rater reliability of the modified Ashworth Scale for spasticity in hemiplegic patients. International Journal of Rehabilitation Research 1992;15:158-161.
   Google Scholar
• Smith C, Birnbaum G, Carter JL, Greenstein J, Lublin FD. Tizanidine treatment of spasticity caused by multiple sclerosis: results of a double-blind, placebo-controlled trial. US Tizanidine Study Group. Neurology 1994;44:S34-S42.
   Google Scholar
• Smith SJ, Ellis E, White S, Moore AP. A double-blind placebo-controlled study of botulinum toxin in upper limb spasticity after stroke or head injury. Clinical Rehabilitation 2000;14:5-13.
   Google Scholar
• Smith AW, Jamshidi M, Lo SK. Clinical measurement of muscle tone using a velocity-corrected modified Ashworth scale. American Journal of Physical Medicine and Rehabi- litation 2002;81:202-206.
   Google Scholar
• Snow BJ, Tsui JK, Bhatt MH, Varelas M, Hashimoto SA, Calne DB. Treatment of spasticity with botulinum toxin: a double-blind study. Annals of Neurology 1990;28:512-515.
   Google Scholar
• Spizzo M, Harris P, Warden-Flood A. Intra-rater and inter- rater reliability of the Tardieu Scale to quantify spasticity in biceps brachii in children with cerebral palsy. Australian Journal of Physiotherapy 2002;48:149.
   Google Scholar
• Steinbok P, Reiner AM, Beauchamp R, Armstrong RW, Cochrane DD. A randomized clinical trial to compare selective posterior rhizotomy plus physiotherapy with physiotherapy alone in children with spastic diplegic cerebral palsy. Developmental Medicine and Child Neurol- ogy 1997;39:178-184.
   Google Scholar
• Tuzson AE, Granata KP, Abel MF. Spastic velocity threshold constrains functional performance in cerebral palsy. Archives of Physical Medicine and Rehabilitation 2003;84:1363-1368.
   Google Scholar
• Van Schaeybroeck P, Nuttin B, Lagae L, Schrijvers E, Borghgraef C, Feys P. Intrathecal baclofen for intractable cerebral spasticity: a prospective placebo-controlled, dou- ble-blind study. Neurosurgery 2000;46:603-609.
   Google Scholar
• Vattanasilp W, Ada L, Crosbie J. Contribution of thixo- tropy, spasticity, and contracture to ankle stiffness after stroke. Journal of Neurology, Neurosurgery and Psychiatry 2000;69:34-39.
   Google Scholar
• Vattanasilp W, Ada L. The relationship between clinical and laboratory measures of spasticity. Australian Journal of Physiotherapy 1999;45:135-139.
   Google Scholar
• Watkins CL, Leathley MJ, Gregson JM, Moore AP, Smith TL, Sharma AK. Prevalence of spasticity post stroke. Clinical Rehabilitation 2002;16:515-522.
   Google Scholar
• Wissel J, Heinen F, Schenkel A et al. Botulinum toxin A in the management of spastic gait disorders in children and young adults with cerebral palsy: A randomized double- blind study of ‘high dose’ versus ‘low-dose’ treatment. Neuropediatrics 1999;30:120-124.
   Google Scholar
• Worley JS, Bennett W, Miller G, Miller M, Walker B, Harmon C. Reliability of three clinical measures of muscle tone in the shoulders and wrists of poststroke patients. American Journal of Occupational Therapy 1991;45:50-58.
   Google Scholar
• Worley JS, Harmon N, Miller FJ, Bowen Hollis S, Harlow S, Briggs V. Reliability of potential clinical measures of muscle tone in the elbow of patients after stroke. American Journal of Occupational Therapy 1996;50:554-560.
   Google Scholar
• Wright FV, Sheil EMH, Wedge JH, Naumann S. Evalua-tion of selective dorsal rhizotomy for the reduction of spasticity in cerebral palsy: a randomized controlled trial. Developmental Medicine and Child Neurology 1998;40:239-247.
   Google Scholar
• Zhang L-Q, Wang G, Nishida T, Xu D, Sliwa JA, Rymer WZ. Hyperactive tendon reflexes in spastic multiple sclerosis: measures and mechanisms of action. Archives of Physical Medicine and Rehabilitation 2000;81:901-909.
   Google Scholar
• Hinderer SR Gupta S. functional outcome measures to assess interventions for spasticity. Archives of Physical Medicine and Rehabilitation 1996;77:1083-1089.
   Google Scholar
• Pandyan AD, Johnson GR, Price CIM, Barnes MP, Rodgers H. A review of the properties and limitations of the Ashworth and modified Ashworth Scales as measures of spasticity. Clinical Rehabilitation 1999;13:373-383.
   Google Scholar
• Wade T. Measurement in neurological rehabilitation. Oxford University press, Oxford; 1992.
   Google Scholar
• Kramer MS. Clinical Epidemiology and Biostatistics. Berlin Heidelberg New York: Springer; 1988. p 11-24.
   Google Scholar
• Lienert GA, Raatz U. Testaufbau und Testanalyse. Weinheim: Beltz, Psychologie Verlags Union, 1994.
   Google Scholar
• Spector PE. Summated rating scale construction. Sage University paper series on quantitative applications in the social sciences, series no. 07-082. Newbury Park London New Delhi: Sage publications; 1992.
   Google Scholar
• Feinstein AR. Clinimetrics. New Haven, CT: Yale Uni- versity Press; 1987.
   Google Scholar
• Landis Jr, Koch GG. The measurement for observer agreement for categorical data. Biometrics 1977;33:159-174.
   Google Scholar
• Burridge JH, Wood DE, Hermens HJ, Voerman GE, Johnson GR, van Wijck F, Platz T, Gregoric M, Hitchcock R, Pandyan AD. Theoretical and methodological consid- erations in the measurement of spasticity. Disability and Rehabilitation, 2005;27(1/2):69-80.
   Google Scholar