Table 1.

Tools for the subjective assessment of spasticity

Scales	Developers	Contents	Behavior assessed	Brief commentary
				Strengths	Weaknesses
Ashworth Scale	Ashworth (1964)8 Naghdi (2008)9: modification	Five‐item scale Investigator reported	Spasticity	A classic and widely used scale Simple, valid, and convenient Allows a rapid impression of severity	Cannot distinguish among types of hypertonia (rigidity, spasticity, or dystonia)
Tardieu Scale	Tardieu (1954)11 Boyd (1999)12: modification	Quality of muscle reaction Angle of muscle reaction	Spasticity	Valid and reliable Can be used to distinguish spasticity and contracture; Can be modified according to disease and affected limbs	Complex Requires experienced investigators
Hypertonia Assessment Tool	Jethwa (2010)13	7‐item, 3‐level scale	Distinguishes spasticity, dystonia, and rigidity	Good validity for spasticity	Validity for dystonia and rigidity has not been confirmed
Gross Motor Function Measure	Palisano (1997)15	Four‐class scale Two versions: 66‐ and 88‐item Investigator reported	Gross motor performance	A reliable and valid classification system Comprehensive	Some children cannot complete this complicated scale Complex Requires experienced investigators
Pediatric Balance Scale	Franjoine (2003)17	Modified from the classic Berg Balance Scale 14‐item, 5‐class scale Investigator reported	Balance	Particular optimization for children Valid and reliable	Subjective
Manual Muscle Test	Wints (1959)	Includes no movement, test movement, and test positions	Function and strength of individual muscles	Valid and reliable	Complicated Requires a highly experienced therapist