Objectives: to establish the reliability of the modified Ashworth scale for measuring muscle tone in a range of muscle collections (elbow.

Objectives: to establish the reliability of the modified Ashworth scale for measuring muscle tone in a range of muscle collections (elbow, wrist, knee and ankle; flexors and extensors) and of the Medical Research Council scale for measuring muscle power in the same muscle collections and their direct antagonists. Design: a cross-sectional application of mind involving repeated measures by pair raters. We estimated reliability using the (kappa)statistic with quadratic weights (Kw) Setting: an acute attack ward, a stroke rehabilitation unit and a continuing care facility. Subjects: family admitted to hospital with an acute thump - 35 patients, median age 73 (interquartile range 65-80) 20 men and 15 women Results: inter- and intra-rater agreement for the measurement of power was serviceable to very good for all ordealed muscle groups (Kw = 084-096 Kw = 070-096) Inter- and intra-rater agreement for the measurement of tone in the turn wrist and knee flexors was convenient to very good (Kw = 073-096 Kw = 077-094) Inter- and intra-rater agreement for the measurement of tone in the ankle plantarflexors was moderate to useful (Kw = 0.45-0.51, Kw = 059-064) Conclusions: the Medical Research Council scale was reliable in the proofed muscle groups. The modified Ashworth scale demonstrated reliability in all proofed muscle groups except the ankle plantarflexors. If reliable measurement of tone at the ankle is required for a specific purport (e.g. to measure the consequence of therapeutic intervention), further work will be necessary.

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