Subject of the scale: Impairment: spasticity |
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Tardieu scale |
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Comment: The Tardieu scale is a generic clinical scale, the objective of which is to assess the spasticity symptom component in a situation of limited articulation in a patient suffering from a lesion of the central nervous system with spastic paresis. The Tardieu scale was developed starting with the clinical examination method developed by Guy Tardieu in 1950-60 [1,2,3]. The central and innovative idea of this clinical method was the measurement of the angle of projection, which characterises each spastic muscle at a given time when one stretches it sufficiently quickly. A first attempt to transform the Tardieu clinical method into a simplified and accessible clinical scale was made by Held and Pierrot-Deseilligny [4] who developed a scale where each muscle was marked in 2 positions, at 3 speeds, by angle of projection and degree of muscular response, i.e. a marking with 12 figures per muscle. Gracies then developed the scale which he named the Tardieu Scale [5,6,7], where each muscle is described by two numbers: one is the angle of spasticity, corresponding to the difference between its length obtained at slow speed (V1) and the angle of projection obtained at rapid speed (V3) the other is the degree of spasticity which represents an ordinal numeration of 0 to 4 describing the type of muscular reaction (with or without clonus, whether tiring or not). This is a simple scale, easy to use, which assesses real spasticity in accordance with its definition and not the muscular tone (Ashworth) because it includes the notion of speed as a parameter contributing to the assessment [8]. Initially it is therefore useful to determine the angle of maximal articular mobilisation obtained at the slowest possible speed (to best eliminate the stretching reflex, at speed V1). Secondly, one mobilises the articulation at the fastest possible speed for the examiner and one notes the angle which appears, if there is one (speed V3). The angle of spasticity is the difference between the angle at V1 and the angle at V3. Finally the intensity of the response is graded from 0 to 4. ATTENTION: 1) The scale retains the benchmark Tardieu position, where 0° is the articular range where the muscle is the shortest. For example, for the ankle, the 90° for the Tardieu assessment corresponds to the 0° of the ankle [tibio-talienne] in anatomical position; the 110° in the Tardieu grading corresponds to 20° of dorsal flexion according to anatomical references. 2) A preliminary version of the scale, where the angle of spasticity does not appear, is erroneously called the Modified Tardieu Scale and has also been tested [16-23]. > Access to the scale is free |
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Psychometric properties:
General comment on reliability: The scale has been evaluated in all languages since language does not affect its use. The assessments have often concerned children with infantile paresis but also the other pathologies of the central nervous system in adults. It has often been tested in specific muscle groups. Reference update: To notify us of a missing reference, please use: contact@scale-library.com |
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