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CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2021; 79(07): 590-597
DOI: 10.1590/0004-282X-anp-2020-0366
Article

Translation and cross-cultural adaptation to Brazilian Portuguese of the Modified Tardieu Scale for muscle tone assessment among patients with spinal cord injury

Tradução e adaptação transcultural para o português do Brasil da Escala de Tardieu Modificada para avaliação do tônus muscular de pacientes com lesão medular
Patrícia Lima do Amaral Santos 
1   Universidade de São Paulo, Faculdade de Medicina, Departamento de Neurologia, São Paulo SP, Brazil.
,
Roberta Caveiro Gaspar 
2   Acreditando Centro de Recuperação Neuromotora Saúde e Bem-estar, São Paulo SP, Brazil.
,
Natália Padula 
2   Acreditando Centro de Recuperação Neuromotora Saúde e Bem-estar, São Paulo SP, Brazil.
,
Daniela Melo Almeida 
1   Universidade de São Paulo, Faculdade de Medicina, Departamento de Neurologia, São Paulo SP, Brazil.
,
Mariana Callil Voos 
1   Universidade de São Paulo, Faculdade de Medicina, Departamento de Neurologia, São Paulo SP, Brazil.
3   Pontifícia Universidade Católica de São Paulo, Faculdade de Ciências Humanas e da Saúde, Curso de Fisioterapia, São Paulo SP, Brazil.
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ABSTRACT

Background: Assessment of muscle tone is of great importance for evaluating people with spinal injuries. Objective: To translate and adapt the Modified Tardieu Scale (MTS) to Brazilian Portuguese and validate its use for evaluating patients with spinal cord injury. Methods: The translation and adaptation of the “Escala de Tardieu Modificada” went through the steps of translation, translation synthesis, back-translation and expert committee meeting. Two evaluators rated the tone of the elbow flexors/extensors, wrist extensors, knee flexors/extensors and ankle plantar flexors of 51 patients with spinal cord injury. These patients were reevaluated after one week. Validation included intra and inter-rater reliability (ICC) and internal and external consistency. The Modified Ashworth Scale (MAS) was used in the evaluations, to investigate the correlations. Results: The Brazilian Portuguese version of the MTS is presented in this study. ICCs ranged from 0.60 to 0.99 (intra and inter-examiner) and there was a moderate to strong correlation with MAS. Conclusions: The MTS proved to be adequate for assessing the muscle tone of people with spinal cord injury in Brazil.

RESUMO

Introdução: A avaliação do tônus muscular é de grande importância para a avaliação de pessoas com lesão muscular. Objetivo: Traduzir e adaptar para a língua portuguesa do Brasil a Modified Tardieu Scale (MTS) e validar seu uso para avaliação de pacientes com lesão medular. Métodos: A tradução e adaptação escala de Tardieu modificada (ETM) passou pelas etapas tradução, síntese de traduções, retrotradução e reunião do comitê de especialistas. Dois avaliadores classificaram o tônus dos músculos flexores/extensores de cotovelo, flexores de punho extensores/flexores de joelho e flexores plantares do tornozelo de 51 pacientes com lesão medular. Os pacientes foram reavaliados após uma semana. A validação incluiu a confiabilidade intra e interexaminadores (ICC), consistência interna e externa. A escala de Ashworth modificada (EAM) foi utilizada nas avaliações, para investigação das correlações. Resultados: A versão em língua portuguesa do Brasil é apresentada no presente estudo. Os ICC variaram de 0,60 a 0,99 (intra e interexaminador) e houve correlação moderada a forte com a EAM. Conclusões: A ETM mostrou-se adequada para avaliação do tônus muscular de pessoas com lesão medular no Brasil.

Keywords:

Spinal cord diseases - Muscle spasticity - Evaluation studies as topic - Spinal cord - Muscle tonus - Spinal cord injuries

Palavras-chave:

Doenças da medula espinhal - Espasticidade muscular - Estudos de avaliação como assunto - Medula espinhal - Tônus muscular - Traumatismos da medula espinhal

Authors’ contribution:

PLAS: data collection, text writing, review; RCG, NP: data collection, review; DMA: data analysis, review; MCV: data analysis, text writing, statistical analysis, review.




Publication History

Received: 29 July 2020

Accepted: 21 October 2020

Article published online:
01 June 2023

© 2021. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • REFERENCES

  • 1 Morris SL, Williams G. A historical review of the evolution of the Tardieu Scale. Brain Inj. 2018;32(5):665-9. https://doi.org/10.1080/02699052.2018.1432890
  • 2 Akpinar P, Atici A, Ozkan FU, Aktas I, Kulcu DG, Sari A, et al. Reliability of the Modified Ashworth Scale and Modified Tardieu Scale in patients with spinal cord injuries. Spinal Cord. 2017 Oct;55(10):944-9. https://doi.org/10.1038/sc.2017.48
  • 3 Annaswamy T, Mallempati S, Allison SC, Abraham LD. Measurement of plantarflexor spasticity in traumatic brain injury: Correlational study of resistance torque compared with the modified Ashworth scale. Am J Phys Med Rehabil. 2007 May;86(5):404-11. https://doi.org/10.1097/PHM.0b013e31804a7d85
  • 4 Mehrholz J, Wagner K, Meißner D, Grundmann K, Zange C, Koch R, et al. Reliability of the modified tardieu scale and the modified ashworth scale in adult patients with severe brain injury: A comparison study. Clin Rehabil. 2005 Oct;19(7):751-9. https://doi.org/10.1191/0269215505cr889oa
  • 5 Mehrholz J, Major Y, Meißner D, Sandi-Gahun S, Koch R, Pohl M. The influence of contractures and variation in measurement stretching velocity on the reliability of the Modified Ashworth Scale in patients with severe brain injury. Clin Rehabil. 2005 Jan;19(1):63-72. https://doi.org/10.1191/0269215505cr824oa
  • 6 Banky M, Williams G. Tardieu Scale. J Physiother. 2017 Apr;63(2):126. https://doi.org/10.1016/j.jphys.2017.01.002
  • 7 Gracies J. Evaluation de la spasticite. Mot cerebrale. 2001;22(1):1-15.
  • 8 Glinsky J. Tardieu Scale. J Physiother. 2016 Oct;62(4):229. https://doi.org/10.1016/j.jphys.2016.07.007
  • 9 Gracies J-M, Burke K, Clegg NJ, Browne R, Rushing C, Fehlings D, et al. Reliability of the Tardieu Scale for Assessing Spasticity in Children With Cerebral Palsy. Arch Phys Med Rehabil. 2010 Mar;91(3):421-8. https://doi.org/10.1016/j.apmr.2009.11.017
  • 10 Singh P, Joshua A, Ganeshan S, Suresh S. Intra-rater reliability of the modified Tardieu scale to quantify spasticity in elbow flexors and ankle plantar flexors in adult stroke subjects. Ann Indian Acad Neurol. 2011 Jan;14(1):23-6. https://doi.org/10.4103/0972-2327.78045
  • 11 Abolhasani H, Ansari NN, Naghdi S, Mansouri K, Ghotbi N, Hasson S. Comparing the validity of the Modified Modified Ashworth Scale (MMAS) and the Modified Tardieu Scale (MTS) in the assessment of wrist flexor spasticity in patients with stroke: Protocol for a neurophysiological study. BMJ Open. 2012 Nov;2(6):e001394. https://doi.org/10.1136/bmjopen-2012-001394
  • 12 Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Guidelines for the process of cross-cultural adaptation of self-report measures. Spine (Phila Pa 1976). 2000 Dec 15;25(24):3186-91. https://doi.org/10.1097/00007632-200012150-00014
  • 13 Linting M, Meulman JJ, Groenen PJF, van der Kooij AJ. Nonlinear Principal Components Analysis: Introduction and Application. Psychol Methods. 2007 Sept;12(3):336-58. https://doi.org/10.1037/1082-989X.12.3.336
  • 14 Koo TK, Li MY. A Guideline of Selecting and Reporting Intraclass Correlation Coefficients for Reliability Research. J Chiropr Med. 2016 Jun;15(2):155-63. https://doi.org/10.1016/j.jcm.2016.02.012
  • 15 Streiner DL. Starting at the beginning: an introduction to coefficient alpha and internal consistency. J Pers Assess. 2003 Feb;80(1):99-103. https://doi.org/10.1207/S15327752JPA8001_18
  • 16 de Vet HCW, Terwee CB, Knol DL, Bouter LM. When to use agreement versus reliability measures. J Clin Epidemiol. 2006 Oct;59(10):1033-9. https://doi.org/10.1016/j.jclinepi.2005.10.015
  • 17 Ansari NN, Naghdi S, Hasson S, Rastgoo M, Amini M, Forogh B. Clinical assessment of ankle plantarflexor spasticity in adult patients after stroke: Inter-and intra-rater reliability of the Modified Tardieu Scale. Brain Inj. 2013;27(5):605-12. https://doi.org/10.3109/02699052.2012.750744
  • 18 Gracies JM. Coefficients of impairment in deforming spastic paresis. Ann Phys Rehabil Med. 2015 Jun;58(3):173-8. https://doi.org/10.1016/j.rehab.2015.04.004
  • 19 Li F, Wu Y, Xiong L. Reliability of a new scale for measurement of spasticity in stroke patients. J Rehabil Med. 2014 Sept;46(8):746-53. https://doi.org/10.2340/16501977-1851
  • 20 Waninge A, Rook RA, Dijkhuizen A, Gielen E, van der Schans CP. Feasibility, test-retest reliability, and interrater reliability of the Modified Ashworth Scale and Modified Tardieu Scale in persons with profound intellectual and multiple disabilities. Res Dev Disabil. 2011 Mar-Apr;32(2):613-20. https://doi.org/10.1016/j.ridd.2010.12.013