Abstract
A myotonometer can objectively quantify changes in muscle tone. The between-days intra-rater reliability in a ward setting for the acute stroke population remains unknown. This study aimed to investigate the device’s between-days intra-rater reliability when used in a ward setting for acute stroke participants. Muscle tone of biceps brachii, brachioradialis, rectus femoris, and tibialis anterior was recorded in the ward at bedside by one physiotherapist on two consecutive days. This study included participants who were within 1 month of their first stroke occurrence. Participants who were medically unstable or who suffered from brain stem injury were excluded. Reliability was assessed by the intraclass correlation coefficient (ICC), standard error of measurement (SEM), smallest real difference (SRD), and the Bland-Altman limits of agreement. The results indicated excellent between-days intra-rater reliability (ICC > 0.75). SEM and SRD show small differences between measurements. The Bland-Altman analysis indicated a tendency of overestimation of the rectus femoris. MyotonPRO demonstrated acceptable reliability when used in a ward setting in those patients with acute stroke. However, results should be interpreted with caution, due to the limitations of the study and the varying level of consistency observed between different muscles.
Highlights
Stroke is among the leading causes of disability worldwide[1]
We found no study that investigated the between-days intra-rater reliability of MyotonPRO when used on a ward to record muscle tone in patients with acute stroke
Medical records show that none of the participants were on medication in order to control spasticity
Summary
Stroke is among the leading causes of disability worldwide[1]. The most common muscular impairment following stroke is spasticity[2], which affects muscle tone. The Ashworth scale or the Modified Ashworth Scale are the most commonly used instruments to assess muscle tone in clinical and research settings[4] These scales have been criticized for their subjective limitations, lack of validity and reliability[5,6]. The latest model has an embedded triaxle accelerometer that allows the device to be held in any direction when taking measurements, enabling different postures and position[2] This should theoretically improve its clinical use in a ward setting where there may be less room for therapists to maneuver into the ideal position, or for patients with reduced mobility such as patients those with acute stroke. We found no study that investigated the between-days intra-rater reliability of MyotonPRO when used on a ward to record muscle tone in patients with acute stroke. The aims of this study were to assess the between-days relative and absolute intra-rater reliability of MyotonPRO used in a ward setting
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