Reliability of the Spinal Cord Assessment Tool for Spastic Reflexes

Abstract

Objective: To assess the reliability of the Spinal Cord Assessment Tool for Spastic Reflexes (SCATS).

Design: Observational reliability study of the SCATS.

Setting: Inpatient rehabilitation unit at an education and research hospital.

Participants: Subjects (N=47) between the ages of 18 and 88 years with spinal cord injury (SCI) and with American Spinal Injury Association Impairment Scale grades from A to D with spasticity, who were at least 6 months postinjury.

Interventions: Not applicable.

Main outcome measures: Interrater and test-retest reliability of the SCATS.

Results: The SCATS had substantial to almost perfect interrater agreement (κ=.669-1.000) between the 2 physiatrists. Test-retest agreement of the SCATS was also substantial to almost perfect (κ=.614-1.000) as well. There was a significant correlation between the SCATS clonus scores and the Modified Ashworth scores of the hip, knee, and ankle. No correlation was found between SCATS extensor spasm scores and Modified Ashworth scores. The SCATS flexor spasm scores were only correlated significantly with the ankle plantar flexor Modified Ashworth scores (P<.05).

Conclusions: The SCATS is a reliable tool for assessing spasm activity and spastic hypertonia in patients with SCI.

Keywords: Muscle hypertonia; Muscle spasticity; Rehabilitation; Spasm; Spinal cord injuries.