Évaluation du tonus musculaire chez les patients ayant subi une lésion cérébrale acquise : une revue systématique

Objective This study determined which muscle tone assessment scale has the best psychometric properties in patients with acquired brain injury. Methods The systematic review included cross-sectional studies of diagnostic accuracy in which the sample consisted of adult patients with acquired brain injury of various etiologies, and the outcomes were the psychometric properties of muscle tone rating scales. The main databases consulted were PubMed, Cochrane Central Register of Controlled Trials and PEDro. Risk of bias and applicability were assessed using QUADAS-2, a specific tool for diagnostic studies. The characteristics of each study were presented in a synaptic table, and the results were described schematically and narratively. Results The search yielded 1056 results, of which only 13 were included in the systematic review after full-text analysis. The population of nine studies involved adult patients with upper motor neuron lesions of various etiologies, while in four studies the sample analyzed consisted of children with cerebral palsy. With regard to spasticity, the Ashworth scale and the modified Ashworth scale demonstrated low to moderate inter-operator reliability and low validity. The modified Ashworth scale, on the other hand, demonstrated high inter-operator reliability in the assessment of upper limb districts. The modified Tardieu scale was found to have low to moderate inter-operator reliability and moderate to high intra-operator reliability, with greater concordance of scores than the modified Ashworth scale. The Hypertonia Assessment Tool, the Barry-Albright Dystonia Scale, the Unified Dystonia Assessment Scale and the Burke-Fahn-Marsden Movement Scale, studied on samples of children with cerebral palsy, showed moderate to good inter-operator reliability and good internal consistency. Conclusion The systematic review identified a series of muscle tone assessment scales and analyzed the psychometric properties of each tool.