Article

AIM: To establish the prevalence and severity of dystonia in a population of
children with cerebral palsy (CP) with hypertonia assessment and measurement tools. METHOD:
A cross-sectional study of 151 children (84 males, 67 females)
with CP who were assessed with the Hypertonia Assessment Tool (HAT) and
Barry-Albright Dystonia scale (BAD) for identification and measurement of
severity of dystonia. HAT dystonia items were assessed for construct and
convergent validity. RESULTS: Distribution by predominant motor type (PMT) was:
85% spastic, 14% dyskinetic, and 1% ataxic. Spastic and dyskinetic groups showed
widespread evidence of dystonia according to HAT profiles and BAD scores. The
dyskinetic PMT group had a higher mean BAD score than the spastic group
(difference of 13 units, 95% CI 9.1-16.4). Dystonia severity (BAD score)
increased linearly across gross motor (p<0.001), manual ability (p<0.001) and
communication functional levels (p<0.001). Divergence was noted in how HAT item
six identified dystonia compared to items one and two. INTERPRETATION: The HAT
provided an estimate of the prevalence of both spasticity and dystonia in a large
CP population, beyond predominant motor type. Dystonia is a common finding in the
spastic PMT group, and its severity increases as motor function worsens. WHAT
THIS PAPER ADDS: Dystonia is readily identified in cerebral palsy (CP) using the
Hypertonia Assessment Tool, regardless of the predominant motor type. Spasticity
and dystonia frequently coexist in the CP population. Severity of dystonia is
inversely related to motor function.
CI - (c) 2017 Mac Keith Press.

Langue : ANGLAIS