Penn Spasm Frequency Scale

Purpose A self-report measure that assess a patient's perception of Spasticity frequency and
severity
Acronym PSFS

Instrument Reviewer(s)
Summary Date
Description Composed of 2-parts; the first is a self report measure with items on 5-point scales
developed to augment clinical ratings of spasticity and provides a more comprehensive
assessment of spasticity.
0 = No spasm
1 = Mild spasms induced by stimulation
2 = Infrequent full spasms occurring less than once per hour
3 = Spasms occurring more than once per hour
4 = Spasms occurring more than 10 times per hour
If the patient indicates no spasms in Part 1, then they do not proceed to Part 2.
The second component of the PSFS is a 3-point scale assessing the severity of
spasms.
ICF Domain Body Structure

Time to Administer Minutes per muscle assessed

Number of Items 2

Equipment Required None

Training Required None

Actual Cost Free

Populations Tested  Spinal Cord Injury

Standard Error of Not Established

Measurement (SEM)
Minimal Detectable Not Established

Change (MDC)
Minimally Clinically Not Established:

Important Difference
(MCID)
Cut-Off Scores Not Applicable

Normative Data Spasticity Across Diagnosis: (Guillaume, et al 2005; n = 138; 30% Multiple
Sclerosis, 26% Spinal Cord Injury, 24% Cerebral Palsy, 7% Traumatic Brain Injury,
13% other; mean age = 35.2 (18.8) years)

PSFS Mean (SD) scores at:

 Baseline 2.70 (1.24)

 Month 12 0.97 (0.95)

Test-retest Reliability Chronic SCI: (Adams et al, 2007)

 Excellent test-retest reliability (assessed 3 times over three consecutive

weeks; ICC = 0.91)

Interrater/Intrarater Not Established

Reliability
Internal Consistency Chronic SCI: (Adams et al, 2007)

 Excellent Internal Consistency ICC = 0.90

Criterion Validity Chronic SCI: (Hornby et al, 2003; n = 12; mean age = 39.2 (range = 24 to 67) years;
mean time since injury = 8.9 years; injury at the 8th thoracic spinal cord level or higher)
Mean Penn scores:
(Predictive/Concurrent)
 Patients taking anti-spastic medication = 3.0 (median = 3.0)
 Penn Spasm Frequency Scale

points
 Patients not taking medication = 2.17 (median = 2.0) points

Construct Validity Chronic SCI: (Adams et al, 2007; n = 61)

(Convergent/  Excellent: PSFS and SCI-SET correlations (r = -0.66)

Discriminant)  Adequate: PSFS and Spasticity Severity correlations (r = 0.58*)

 Excellent: PSFS and Spasticity Impact correlations (r = 0.67*)
 Poor: PSFS and FIM Motor Score correlations (r = -0.05)
 Adequate: PSFS and QLI Health and Functioning Sub scale correlations (r
= -0.46*)
o p < .001

Spasticity Across Diagnosis: (Guillaume, et al 2005)

Ashworth and Penn Scores at Baseline and 12 months:

Measure Month n mean (SD) p
Ashworth assessments
Cerebral-origin spasticity
Lower extremities Baseline 52 4.02 (0.92)

Month 12 39 1.96 (0.78) <.001

Upper extremities Baseline 52 3.58 (1.25)

Month 12 39 2.07 (0.86) <.001

Spinal-origin spasticity
Lower extremities Baseline 86 3.68 (0.81)

Month 12 65 1.92 (0.75) <.001

Upper extremities Baseline 85 1.65 (0.78)

Month 12 65 1.34 (0.50) <.001

PSFS scores Baseline 134 2.70 (1.24)

Month 12 102 0.97 (0.95) <.001

Spasticity Outcomes Review: (Hsieh et al, 2008)

 Adequate Correlation between the PSFS and the Ashworth Scale (r = 0.40
to 0.51)
 Adequate Correlation between the PSFS and the Spinal Cord Assessment
Tool for Spastic reflexes (SCATS; r = 0.40 to 0.59*)

*p < 0.05
Content Validity Not Established

Face Validity Not Statistically Assessed

Floor/Ceiling Effects Not Established:

Responsiveness Not Established:

Professional Association
Recommendations
Considerations  May not adequately record flexor and extensor spasms (Hsieh et al, 2008)
 The modified PSFS is a two component self-report scale to augment
clinical ratings of spasticity