Episode 32 – Modified Ashworth Scale

Watch the video version of this Q&A episode on YouTube – https://youtu.be/aJPH0JyPB3E

A physical therapist administers the Modified Ashworth Scale to a patient with a suspected neurological injury. What is the MOST accurate description of the starting position when testing the elbow flexors? 

1. Full extension of the elbow
2. 45 degrees of elbow flexion
3. 90 degrees of elbow flexion
4. 145 degrees of elbow flexion

Welcome back to the Scorebuilders’ Q and A Podcast! This podcast provides members of the Scorebuilders’ team with the opportunity to explore challenging multiple-choice examination questions with students actively preparing for the licensing examination. My name is Scott Giles and I will be your host for today’s journey.

Ready? Let’s go!

A physical therapist administers the Modified Ashworth Scale to a patient with a suspected neurological injury. What is the MOST accurate description of the starting position when testing the elbow flexors? 

1. Full extension of the elbow
2. 45 degrees of elbow flexion
3. 90 degrees of elbow flexion
4. 145 degrees of elbow flexion

Modified Ashworth Scale
The Modified Ashworth Scale is a widely used qualitative scale for the assessment of spasticity; it measures the amount of resistance to passive stretch. 

The Modified Ashworth Scale has a minimum grade of 0 and a maximum grade of 4. Since the tool measures the amount of resistance to passive stretch, the elbow would initially be in a fully flexed position and moved toward a fully extended position when testing the elbow flexors.

Let’s explore each of the options:

Option 1 - Full extension of the elbow
Full extension of the elbow would be the position of the elbow at the conclusion of the testing procedure or would be the initial position for testing of the elbow extensors.

Option 2 - 45 degrees of elbow flexion
45 degrees of elbow flexion would not be an adequate amount of flexion for the starting position since there would not be ample time to examine the resistance to passive stretch.

Option 3 - 90 degrees of elbow flexion
90 degrees of elbow flexion would not be an ideal starting position since the elbow should be fully flexed.

Option 4 - 145 degrees of elbow flexion
145 degrees of elbow flexion closely approximates normal full elbow flexion (i.e., 150 degrees). This position provides the therapist with the best opportunity to assess the amount of resistance of the elbow flexors to passive stretch while the elbow is extended.

The correct answer is Option 4

Let’s explore the all student data:
19% of students selected Option 1, Full extension of the elbow
15% of students selected Option 2, 45 degrees of elbow flexion
21% of students selected Option 3, 90 degrees of elbow flexion
45% of students selected Option 4, 145 degrees of elbow flexion - the correct response

System Classification
This question is a Neuromuscular and Nervous Systems question which represents approximately 24% of all exam items.

Content Outline Classification
This question is a Physical Therapy Examination question which represents approximately 24% of all exam items.

Level Classification
This question is a Level 1 question since the question requires students to possess basic foundational academic knowledge. Remediation of Level 1 questions occurs through academic review of entry-level content using textbooks, review books, Basecamp, and flash cards.

Academic Focus Area
Looking to review related academic content? Check out page 274 in PTEXAM: The Complete Study Guide.

Thanks for joining us on the Scorebuilders Q and A podcast! See you next week!