Test–retest reliability of the Dyskinesia Impairment Scale: measuring dystonia and choreoathetosis in dyskinetic cerebral palsy

Vanmechelen, Inti; Dan, Bernard; Feys, Hilde; Monbaliu, Elegast

doi:10.1111/dmcn.14424

Cited by 11 publications

(11 citation statements)

References 19 publications

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“…Thirdly, the DIS evaluates only the presence and severity of dystonia and choreoathetosis, whereas the BFM is constructed in such a way that the impact of dystonia on function is, by default, evaluated along with the severity of dystonia, which may complicate the interpretation of the results. Finally, the DIS has showed high inter-rater and test-retest reliability and validity in DCP [14,15].…”

Section: Introductionmentioning

confidence: 90%

Reliability and Validity of the Dyskinesia Impairment Scale in Children and Young Adults with Inherited or Idiopathic Dystonia

Danielsson

Vanmechelen

Lidbeck

et al. 2020

JCM

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Background: The Dyskinesia Impairment Scale (DIS) is a new assessment scale for dystonia and choreoathetosis in children and youth with dyskinetic cerebral palsy. Today, the Burke–Fahn–Marsden Dystonia Rating Scale (BFM) is mostly used to assess dystonia in children with inherited dystonia. The aim of this study was to assess reliability and validity of the DIS in children and youth with inherited or idiopathic dystonia. Methods: Reliability was measured by (1) the intraclass correlation coefficients (ICCs) for inter-rater and test-retest reliability, as well as (2) standard error of measurement (SEM) and minimal detectable difference (MDD). For concurrent validity of the DIS-dystonia subscale, the BFM was administered. Results: In total, 11 males and 9 females (median age 16 years and 7 months, range 6 to 24 years) were included. For inter-rater reliability, the ICCs for the DIS total score and the dystonia and choreoathetosis subscale scores were 0.83, 0.87, and 0.71, respectively. For test-retest reliability, the ICCs for the DIS total score and the dystonia and choreoathetosis subscale scores were 0.95, 0.88, and 0.93, respectively. The SEM and MDD for the total DIS were 3.98% and 11.04%, respectively. The Spearman correlation coefficient between the dystonia subscale and the BFM was 0.88 (p < 0.01). Conclusions: Good to excellent inter-rater, test-retest reliability, and validity were found for the total DIS and the dystonia subscale. The choreoathetosis subscale showed moderate inter-rater reliability and excellent test-retest reliability. The DIS may be a promising tool to assess dystonia and choreoathetosis in children and young adults with inherited or idiopathic dystonia.

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Section: Introductionmentioning

confidence: 90%

Reliability and Validity of the Dyskinesia Impairment Scale in Children and Young Adults with Inherited or Idiopathic Dystonia

Danielsson

Vanmechelen

Lidbeck

et al. 2020

JCM

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“…In the first step towards developing the adapted DIMS protocol, the DIS was examined thoroughly for dystonia and choreoathetosis characteristics which would be relevant to be included in the DIMS [9,[14][15][16]. The DIS measures the presence and severity of dystonia and choreoathetosis over 12 body regions; i.e., central body (eyes, mouth, neck and trunk) and limbs (upper and lower, proximal and distal limbs) [14].…”

Section: Development Of the Dyskinesia Impairment Mobility Scale (Dims)mentioning

confidence: 99%

“…To date, presence and severity of dystonia and choreoathetosis are measured using the Dyskinesia Impairment Scale (DIS) [9,[14][15][16], a video-based tool which measures the movement disorders during requested but voluntary activities and rest postures. The DIS measures requested but voluntary activities in a controlled environment and may, therefore, not provide information about the occurrence of the movement disorders in a more real-life context, such as steering a powered wheelchair using a head/foot steering system.…”

Section: Introductionmentioning

confidence: 99%

Development of the Dyskinesia Impairment Mobility Scale to Measure Presence and Severity of Dystonia and Choreoathetosis during Powered Mobility in Dyskinetic Cerebral Palsy

et al. 2019

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The majority of individuals with dyskinetic cerebral palsy cannot use powered mobility with a joystick, due to the lack of manual abilities by the severe presence of dystonia and choreoathetosis. Reliable measurements of these movement disorders is indispensable for good evaluation towards evidence–based insights during powered mobility. This study aimed to develop and assess the Dyskinesia Impairment Mobility Scale (DIMS), a video–based tool to measure presence and severity of dystonia and choreoathetosis during powered mobility. DIMS was measured for the neck and arms region during five mobility tasks. Interrater reliability, test–retest reliability, internal consistency and concurrent validity of the DIMS were assessed. Interrater reliability coefficients ranged between 0.68 and 0.87 for the total DIMS, and the dystonia and choreoathetosis subscales. Test–retest reliability was moderate to excellent (range 0.51–0.93) while Cronbach’s alpha was good (range 0.69–0.81) for the total scale and subscale scores. Concurrent validity showed during mobility tasks significant correlations with rest postures in the arm region, and with requested but voluntary activity in the neck region. The DIMS reliably measures the presence and severity of the movement disorders during powered mobility, increasing insights into the underlying mechanisms of independent mobility. This scale may therefore be a promising tool to evaluate mobility training.

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“…standard error of measurement and smallest detectable change), should be used to determine if individual changes are due to treatment and not to measurement error. 25 Feasibility of the full DIS protocol is limited because many activities items of the DIS could not be performed in non-ambulatory children. Future research should elaborate the activity part of the DIS scale towards a reduction of activity items for this group of patients.…”

Section: Implications and Future Perspectivesmentioning

confidence: 99%

Use of the Dyskinesia Impairment Scale in non‐ambulatory dyskinetic cerebral palsy

Haberfehlner

Bonouvrié

Boeschoten

et al. 2019

Develop Med Child Neuro

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Aim To assess the responsiveness, concurrent validity, and feasibility of the Dyskinesia Impairment Scale (DIS) in non‐ambulatory patients with dyskinetic cerebral palsy (CP). Method The study is a secondary analysis of data collected in the IDYS trial, a randomized controlled trial on the effects of intrathecal baclofen (ITB). The DIS and Barry–Albright Dystonia Scale (BADS) were conducted at baseline and after 3 months of ITB or placebo treatment. Responsiveness was assessed by comparing the effect sizes and correlation of change after treatment between the DIS and BADS. Concurrent validity was evaluated by assessing the correlations between scales. Feasibility was evaluated for each DIS item by the number of participants who successfully accomplished the item. Results Thirty‐three non‐ambulatory patients (9 females, 24 males) with dyskinetic CP (ITB‐treated: n=17, mean [SD] age: 14y 1mo [4y 1mo]; placebo‐treated: n=16, mean [SD] age: 14y 7mo [4y]) were included in the study. The effect sizes for BADS and DIS were similar in The ITB‐treated group (−0.29 and −0.22 respectively). Changes after treatment on the DIS dystonia subscale correlated with changes on the BADS (r=0.64; p<0.001). The DIS dystonia subscale and BADS correlated at baseline and follow‐up (r=0.78; p<0.001 and r=0.79; p<0.001). Not all DIS activity items could be performed in this sample of patients. Interpretation For non‐ambulatory patients with dyskinetic CP, the responsiveness of the DIS equalled the responsiveness of BADS. Concurrent validity was adequate. Feasibility for activity items was restricted in patients with severe dyskinetic CP. What this paper adds The Dyskinesia Impairment Scale (DIS) and Barry–Albright Dystonia Scale showed similar responsiveness in non‐ambulatory patients with dyskinetic cerebral palsy (CP). No floor or ceiling effect was observed for DIS in non‐ambulatory participants. The concurrent validity of DIS was adequate in non‐ambulatory participants. Patients with dyskinetic CP in Gross Motor Function Classification System levels IV and V could not perform all DIS activity items.

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Test–retest reliability of the Dyskinesia Impairment Scale: measuring dystonia and choreoathetosis in dyskinetic cerebral palsy

Cited by 11 publications

References 19 publications

Reliability and Validity of the Dyskinesia Impairment Scale in Children and Young Adults with Inherited or Idiopathic Dystonia

Reliability and Validity of the Dyskinesia Impairment Scale in Children and Young Adults with Inherited or Idiopathic Dystonia

Development of the Dyskinesia Impairment Mobility Scale to Measure Presence and Severity of Dystonia and Choreoathetosis during Powered Mobility in Dyskinetic Cerebral Palsy

Use of the Dyskinesia Impairment Scale in non‐ambulatory dyskinetic cerebral palsy

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