Interobserver reliability of the Australian Spasticity Assessment Scale (ASAS)

Sarah Love, N. Gibson, N. Smith, N. Bear, Eve Blair

Research output: Contribution to journalArticlepeer-review

40 Citations (Scopus)


© 2016 Mac Keith Press. Aim: The aim of this paper is to present the Australian Spasticity Assessment Scale (ASAS) and to report studies of its interrater reliability. The ASAS identifies the presence of spasticity by confirming a velocity-dependent increased response to rapid passive movement and quantifies it using an ordinal scale. Method: The rationale and procedure for the ASAS is described. Twenty-two participants with spastic CP (16 males; age range 1y 11mo-15y 3mo) who had not had botulinum neurotoxin-A within 4 months, or bony or soft tissue surgery within 12 months, were recruited from the spasticity management clinic of a tertiary paediatric teaching hospital. Fourteen muscles in each child were assessed by each of three experienced independent raters. ASAS was recorded for all muscles. Interrater reliability was calculated using the weighted kappa statistic (quadratic weighting; ?qw) for individual muscles, for upper limbs, for lower limbs, and between raters. Results: The weighted kappa ranged between 0.75 and 0.92 for individual muscle groups and was 0.87 between raters. Interpretation: The ASAS complies with the definition of spasticity and is clinically feasible in paediatric settings. Our estimates of interrater reliability for the ASAS exceed that of the most commonly used spasticity scoring systems. What this paper adds: A new scale that satisfies all criteria for usefulness of a clinical assessment tool for spasticity in children. The scale has greater interrater reliability than the most frequently used clinical assessment tools for measuring spasticity. Developmental Medicine and Child Neurology
Original languageEnglish
Pages (from-to)18-24
Number of pages7
JournalDevelopmental Medicine and Child Neurology
Publication statusPublished - 1 Feb 2016


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