Inter-rater agreement of the canine modified Ashworth scale for assessment of limb tone in dogs presenting with acute myelopathic signs.

The CaMAS shows good inter-rater reliability for canine muscle tone assessment, improving significantly with rater experience.

This prospective observational study evaluated the inter-rater reliability of the Canine Modified Ashworth Scale (CaMAS), an adaptation of a human spasticity assessment tool, for measuring muscle tone in dogs presenting with acute myelopathic signs. One hundred dogs presenting to a single neurology referral center between November 2023 and October 2024 were independently assessed by two raters using the CaMAS. Inter-rater agreement was quantified using Kendall's tau coefficient of concordance. Overall inter-rater agreement was good (τ > 0.64), with stronger agreement in pelvic limbs (τ > 0.75) compared to thoracic limbs (τ > 0.64). Dogs with thoracolumbar lesions showed higher agreement (τ = 0.69–0.81) than those with cervical lesions (τ = 0.42–0.62). Medium and large breed dogs demonstrated better agreement than small breeds. Notably, agreement improved with rater experience: the first 50 cases yielded τ = 0.41–0.79, while the last 50 cases improved to τ = 0.73–0.93, suggesting a meaningful learning curve. Limitations include the scale's origin as a human tool, potential anatomical and biomechanical incompatibilities, and the influence of patient positioning and behavior on assessment outcomes. Intra-rater reliability was not evaluated. Despite these limitations, the CaMAS demonstrates promising inter-rater reliability and could serve as a standardized, objective adjunct to neurological examination for muscle tone assessment in dogs, particularly with adequate rater training.

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