Correlation of Modified Ashworth Scale and Dynamic Gait Index in Chronic Stroke Patients with Middle Cerebral Artery Infarct

Purpose of the study: Stroke is defined as the sudden loss of neurological function caused by an interruption of the blood flow to the brain. Almost 80% of the stroke patients have middle cerebral artery as the most commonly involved artery both due to hemorrhage as well as infarction. The prevalence of spasticity in the post stroke population is estimated at 38-60%of patients one year after stroke6. The Modified Ashworth Scale is the most frequently used and valid scale for measurement of both upper and lower limb spasticity. The Dynamic Gait Index is also a reliable and valid scale used for measuring gait outcome in chronic stroke patients. The aim of the study is to find whether there exists correlation these two measures in patients with MCA involvement thus helping us determine if a correlation exists between spasticity and gait.

Objective: To correlate the MAS scores of upper &lower extremity with DGI in relation to side of involvement. To correlate the MAS scores of lower extremity with DGI. To find out the maximally affected gait parameters on DGI To compare the DGI scores of right sided hemiplegics with left sided hemiplegics.

Design: Co-relational study.

Study Setting: Neurological department of Pad Dr D.Y. Patil Hospital, Nerul; Balaji old age centre, Koparkhairne Navi Mumbai.

Participants: patients with more than 3months of post stroke duration with involvement of MCA and able to walk atleast 10meters with or without support.

Interventions: Not applicable.

Main Outcome Measures: All subjects were evaluated for the MAS (Modified Ashworth scale) grading and DGI (Dynamic Gait Index) scores.

Results: The MAS scores of the lower extremity correlates significantly with DGI scores (p 0.0043), also the subjects with left hemispherical involvement had good correlation with MAS scores (p U/L 0.0458 p L/L 0.0368). Staircase climbing is the most affected DGI component.(31.20%)

Conclusions: The MAS scores of lower extremity in chronic MCA stroke patients show correlation with the DGI scores with Staircase climbing being the most affected component and correlation between MAS and DGI exists strongly in subjects with Left hemispherical involvement.