PUBLIC LIBRARY / CALCULATOR

Modified Ashworth Scale

Grades spasticity by muscle resistance to passive stretch, muscle by muscle. A reference for botulinum toxin indications, follow-up and rehabilitation.

Calculate with transparency

Check the population, units and version. The result shows the formula or classification; it does not make an automatic treatment decision.

Preparing the form…

Check the method
Enter the data
Check the result

Method · Limits of application

Modified Ashworth/Bohannon–Smith 1987: 0/1/1+/2/3/4; specific grade 1+

Clinical grading of resistance to passive movement, distinct from muscle strength. The original reliability study examined elbow flexors in patients with intracranial lesions. That performance cannot automatically be transferred to every joint or neurological condition.

Conditions of use

Check the population, units, inclusion and exclusion criteria, and version in the original source. A result alone does not establish a diagnosis, discharge decision or prescription.

Documented parameters

Resistance to passive movement (over approximately 1 second)

3/3 reference cases checked. Numerical tests are not clinical validation.

Sources and documentation

Documented formula

Transcribed from the source or a recorded revision; this is not a clinical recommendation.

With the patient relaxed and supine, passively move the segment through its full range in about 1 second and select the resistance grade. Bohannon and Smith added grade 1+ to the original Ashworth scale.

References

Bohannon RW, Smith MB. Interrater reliability of a modified Ashworth scale of muscle spasticity. Phys Ther, 1987.

Identifier: escala-de-ashworth-modificada

Original clinical content: Brazilian Portuguese.

Method version

Modified Ashworth/Bohannon–Smith 1987: 0/1/1+/2/3/4; specific grade 1+

escala-de-ashworth-modificada@native-2026-10-03+0819551b5bae

Source for the active edition

The bibliographic edition identifies the source. By itself, it proves neither full conformity of the formula nor clinical approval.

Synthetic cases checked (3)

Synthetic cases for checking the implementation, with no patient data.

Case 1

reference-001

Inputs

Resistance to passive movement (over approximately 1 second): 0 – No increase in muscle tone

{
  "grau": "0"
}

Expected result

{
  "grade": "0"
}

Actual result

{
  "grade": "0"
}

Case 2

reference-002

Inputs

Resistance to passive movement (over approximately 1 second): 1+ – Slight increase: catch followed by minimal resistance through less than half the range

{
  "grau": "1p"
}

Expected result

{
  "grade": "1+"
}

Actual result

{
  "grade": "1+"
}

Case 3

reference-003

Inputs

Resistance to passive movement (over approximately 1 second): 3 – Considerable increase: passive movement difficult

{
  "grau": "3"
}

Expected result

{
  "grade": "3"
}

Actual result

{
  "grade": "3"
}

Code and reproducibility

This tool’s code on GitHub

Download code and tests

Sources, version and reproduction instructions

The code tests are technical checks. Clinical approval and professional translation review are recorded separately.

Relationship with cancer research

General context — relationship to be defined

A resource for general clinical contexts. This edition does not assign a specific oncological relationship; selecting it for a study requires a justified question, population and purpose.