Table of Contents
In the original Ashworth Scale, resistance to passive movement about a joint with varying degrees of velocity is measured on a scale of 0 (no resistance) to 4 (rigidity). In the modified Ashworth Scale, a 1+ scoring category is added to indicate resistance through less than half of the movement (Bohannon & Smith, 1987).
Author of Tool:
Richard Bohannon PT, PhD and Melissa Smith, PT
Brashear, A., Zafonte, R., et al. (2002). “Inter-and intrarater reliability of the Ashworth Scale and the Disability Assessment Scale in patients with upper-limb poststroke spasticity* 1.” Archives of physical medicine and rehabilitation 83(10): 1349-1354.
Gregson, J., Leathley, M., et al. (1999). “Reliability of the Tone Assessment Scale and the modified Ashworth scale as clinical tools for assessing poststroke spasticity.” Archives of physical medicine and rehabilitation 80(9): 1013-1016. Find it on PubMed
Haas, B., Bergström, E., et al. (1996). “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 34(9): 560-564.
Primary use / Purpose:
The Ashworth Scale was initially designed to examine the effects of anti spasticity drugs on spasticity in Multiple Sclerosis (MS). The Modified Ashworth Scale (MAS) purports to measure spasticity in patients with lesions of the central nervous system.
Modified Ashworth Scale Instructions
General Information (derived Bohannon and Smith, 1987):
- Place the patient in a supine position
- If testing a muscle that primarily flexes a joint, place the joint in a maximally flexed position and move to a position of maximal extension over one second (count "one thousand one”)
- If testing a muscle that primarily extends a joint, place the joint in a maximally extended position and move to a position of maximal flexion over one second (count "one thousand one”)
- Score based on the classification below
Scoring (taken from Bohannon and Smith, 1987):
- No increase in muscle tone
- Slight increase in muscle tone, manifested by a catch and release or by minimal resistance at the end of the range of motion when the affected part(s) is moved in flexion or extension
- More marked increase in muscle tone through most of the ROM, but affected part(s) easily moved
- Considerable increase in muscle tone, passive movement difficult
- Affected part(s) rigid in flexion or extension
The patient should be instructed to relax.
Modified Ashworth Scale Testing Form
Name: Date: Muscle Tested Score
Reference for test instructions: