Assesses three types of spastic motor behaviors in SCI patients - clonus, flexor spasms, and extensor spasms.
3 sub-scales
5-10 minutes
Adolescent
13 - 17
yearsAdult
18 - 64
yearsElderly Adult
65 +
yearsInitially reviewed by the Rehabilitation Measures Team in 2011; Updated by Phyllis Palma, PT, DPT and the SCI EDGE task force of the Neurology Section of the APTA in 9/2012.
Recommendations for use of the instrument from the Neurology Section of the American Physical Therapy Association’s Multiple Sclerosis Taskforce (MSEDGE), Parkinson’s Taskforce (PD EDGE), Spinal Cord Injury Taskforce (SCI EDGE), Stroke Taskforce (StrokEDGE), Traumatic Brain Injury Taskforce (TBI EDGE), and Vestibular Taskforce (VEDGE) are listed below. These recommendations were developed by a panel of research and clinical experts using a modified Delphi process.
For detailed information about how recommendations were made, please visit:
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Abbreviations: |
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HR |
Highly Recommend |
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R |
Recommend |
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LS / UR |
Reasonable to use, but limited study in target group / Unable to Recommend |
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NR |
Not Recommended |
Recommendations for use based on acuity level of the patient:
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Acute (CVA < 2 months post) (SCI < 1 month post) (Vestibular < 6 weeks post) |
Subacute (CVA 2 to 6 months) (SCI 3 to 6 months) |
Chronic (> 6 months) |
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SCI EDGE |
LS |
LS |
LS |
Recommendations based on SCI AIS Classification:
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AIS A/B |
AIS C/D |
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SCI EDGE |
LS |
LS |
Recommendations for entry-level physical therapy education and use in research:
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Students should learn to administer this tool? (Y/N) |
Students should be exposed to tool? (Y/N) |
Appropriate for use in intervention research studies? (Y/N) |
Is additional research warranted for this tool (Y/N) |
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SCI EDGE |
No |
No |
No |
Not reported |
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Acute SCI: (Kumru et al, 2010; n = 15; mean age = 36.2 (15.8) years; mean time since SCI = 7.3 (3.9); Spasticity affected both legs in all participants)
Significant improvement in spasticity of the lower limb was experienced in patients after active high frequency repetitive transcranial magnetic stimulation (rTMS), results follows:
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SCAT Norm Data in Experimental Conditions: |
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Time of Stimulation |
Active |
Sham |
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Before Stimulation |
5.9 (2.3) |
5.2 (1.9) |
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After First Session |
4.2 (1.8) |
4.7 (2.3) |
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After Last Session |
4.6 (1.8) |
4.5 (2.1) |
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One Week After Stimulation |
4.2 (2.2) |
4.5 (2.1) |
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p |
.01 |
.18 |
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p value refers to the results of Friedman’s test |
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Acute and Chronic SCI: (Benz st al, 2005; n = 11; ages ranged from 16 to 65; months post injury ranged from 3 to 360 months)
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Correlation of the SCATS and Kinematic and Electromyographic Measures |
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Laboratory based measure |
Clinical measure |
Strength |
rho |
p |
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Vastus medialis duration |
Extensor SCATS |
Excellent |
.90 |
< 0.001 |
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Soleus duration |
Extensor SCATS |
Excellent |
.70 |
< 0.001 |
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Extensor SCATS |
Extensor SCATS |
Excellent |
.94 |
< 0.001 |
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Medial gastrocnemius duration |
Clonus SCATS |
Excellent |
.69 |
0.002 |
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Clonus SCATS |
Clonus SCATS |
Excellent |
.90 |
< 0.001 |
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Ankle excursion angle |
Flexor SCATS |
Excellent |
.69 |
< 0.001 |
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Knee excursion angle |
Flexor SCATS |
Excellent |
.81 |
< 0.001 |
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Hip excursion angle |
Flexor SCATS |
Excellent |
.82 |
< 0.001 |
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Flexor SCATS |
Flexor SCATS |
Excellent |
.87 |
< 0.001 |
Acute and Chronic SCI: (Benz st al, 2005)
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SCATS, Ashworth Scale, and PSFS Correlations~: |
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Ashworth Hip |
Ashworth Knee |
Ashworth Ankle |
SCATS Clonus |
SCATS Flexion |
SCATS Extension |
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PSFS |
.43 (A) |
.43 (A) |
.51 (A) |
.59* (A) |
.41 (A) |
.40 |
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Ashworth hip |
.90** (E) |
.67* (E) |
.56 (A) |
.55* (A) |
.98** (E) |
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Ashworth knee |
.77** (E) |
.65* (E) |
.47 (A) |
.88** (E) |
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Ashworth ankle |
.60* (E) |
.40 (A) |
.61* (E) |
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SCATS clonus |
.35 (A) |
.59* (A) |
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SCATS flexion |
.56* (A) |
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Strength: (E) = Excellent (A) = Adequate |
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PSFS = Penn Spasm Frequency Scale ~ Spearman Rank-Order Correlation *Significant at P < 0.05 **Significant at P < 0.01 |
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Benz, E. N., Hornby, T. G., et al. (2005). "A physiologically based clinical measure for spastic reflexes in spinal cord injury." Arch Phys Med Rehabil 86(1): 52-59.
Hsieh, J., Wolfe, D., et al. (2007). "Spasticity outcome measures in spinal cord injury: psychometric properties and clinical utility." Spinal Cord 46(2): 86-95.
Kumru, H., Murillo, N., et al. (2010). "Reduction of Spasticity With Repetitive Transcranial Magnetic Stimulation in Patients With Spinal Cord Injury." Neurorehabilitation and neural repair 24(5): 435.
We have reviewed more than 500 instruments for use with a number of diagnoses including stroke, spinal cord injury and traumatic brain injury among several others.