The relationship between spasticity in young children (18 months of age) with cerebral palsy and their gross motor function development

Gorter, Jan Willem; Verschuren, Olaf; Riel, Laura van

doi:10.1186/1471-2474-10-108

Cited by 40 publications

(36 citation statements)

References 29 publications

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“…Gorter et al [29], who assessed the relationship between spasticity and gross motor function of children with 18 months old, showed that the non-affected children presented no difficulties, however, the relationship between spasticity and gross motor function decreased when including other characteristics such as muscle weakness, sensi-tivity disturbances, perception, cognition and the child's environment, which the ultimate may have influence on gross motor function.…”

Section: Discussionmentioning

confidence: 99%

Functional capacity and assistance from the caregiver during daily activities in Brazilian children with cerebral palsy

Malheiros¹,

Monteiro²,

Silva³

et al. 2013

Int Arch Med

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BackgroundCerebral Palsy (CP) presents changes in posture and movement as a core characteristic, which requires multiprofessional clinical treatments during children’s habilitation or rehabilitation. Besides clinical treatment, it is fundamental that professionals use evaluation systems to quantify the difficulties presented to the individual and their families in their daily lives. We aimed to investigate the functional capacity of individuals with CP and the amount of assistance required by the caregiver in day-to-day activities.MethodsTwenty patients with CP, six-year-old on average, were evaluated. The Pediatric Evaluation Inventory of Incapacities was used (PEDI - Pediatric Evaluation Disability Inventory), a system adapted for Brazil that evaluates child's dysfunction in three 3 dimensions: self-care, mobility and social function. To compare the three areas, repeated measures analysis of variance (ANOVA) were used.ResultsWe found the following results regarding the functional capacity of children: self-care, 27.4%, ±17.5; mobility, 25.8%, ±33.3 and social function, 36.3%, ±27.7. The results of the demand of aid from the caregiver according to each dimension were: self-care, 9.7%, ±19.9; mobility, 14.1%, ± 20.9 and social function, 19.8%, ±26.1.ConclusionWe indicated that there was no difference between the performance of the subjects in areas of self-care, mobility and social function considering the functional skills and assistance required by the caregiver.

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Section: Discussionmentioning

confidence: 99%

Functional capacity and assistance from the caregiver during daily activities in Brazilian children with cerebral palsy

Malheiros¹,

Monteiro²,

Silva³

et al. 2013

Int Arch Med

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“…We recruited a sample of convenience from a spasticity management service in a tertiary setting that had a higher proportion of children presenting with GMFCS levels I to III. Based on weak association of spasticity with gross motor function, [26][27][28] we believe it unlikely that GMFCS level would affect the ability of the ASAS to detect and score spasticity.A second limitation is the distribution of our ASAS scores, with many zero scores and few scores of four. This is consistent with our clinical expectation of lower spasticity scores in children who have been engaged in tertiarylevel spasticity management.…”

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confidence: 93%

Interobserver reliability of the Australian Spasticity Assessment Scale (ASAS)

Love

Gibson

Smith

et al. 2016

Develop Med Child Neuro

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ASASAustralian Spasticity Assessment Scale ICC Intraclass correlation coefficient MAS Modified Ashworth Scale MTS Modified Tardieu Scale RPM Rapid passive movement AIM The aim of this paper is to present the Australian Spasticity Assessment Scale (ASAS) and to report studies of its interrater reliability. The ASAS identifies the presence of spasticity by confirming a velocity-dependent increased response to rapid passive movement and quantifies it using an ordinal scale.METHOD The rationale and procedure for the ASAS is described. Twenty-two participants with spastic CP (16 males; age range 1y 11mo-15y 3mo) who had not had botulinum neurotoxin-A within 4 months, or bony or soft tissue surgery within 12 months, were recruited from the spasticity management clinic of a tertiary paediatric teaching hospital. Fourteen muscles in each child were assessed by each of three experienced independent raters. ASAS was recorded for all muscles. Interrater reliability was calculated using the weighted kappa statistic (quadratic weighting; j qw ) for individual muscles, for upper limbs, for lower limbs, and between raters.RESULTS The weighted kappa ranged between 0.75 and 0.92 for individual muscle groups and was 0.87 between raters.INTERPRETATION The ASAS complies with the definition of spasticity and is clinically feasible in paediatric settings. Our estimates of interrater reliability for the ASAS exceed that of the most commonly used spasticity scoring systems.Cerebral palsy (CP) is the most frequent physical disability of childhood. 1,2 It can be categorized as primarily spastic, dyskinetic, or ataxic, with spasticity being the most common motor disorder occurring in children (86.6%).2 Spasticity may be present as the sole motor disorder, but more usually it occurs in combination with others.Assessment of spasticity is only one part of the clinical assessment of the child with CP or similar conditions. There is still much discussion in the literature about whether the cascade of events from spasticity to progressive deformity contributes to loss of functional ability. 3,4 Despite current controversy around the contribution of spasticity both to progressive deformity and to functional ability, change in the degree of spasticity is one of the most commonly measured outcomes in this population. Reliable and valid identification and quantification of spasticity are important for clinical decision making, for the reliable evaluation of interventions aimed at improving function, 5 as well as for epidemiological and research databases.Spasticity is only one of the signs of upper motor neuron syndrome, but the term is frequently misused in clinical practice to refer to several forms of hypertonia, and it is even occasionally misused to refer to the entire group of motor dysfunctions of upper motor neuron syndrome. Most clinicians specializing in the treatment of children with upper motor neuron lesions have little difficulty in recognizing spasticity. However, differentiating hypertonia, spasticity, and dystonia, and appropria...

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“…Spasticity was redefined as 'disordered sensori-motor control, resulting from UMN lesion, presenting as intermittent or sustained involuntary activation of muscles' (Pandyan et al, 2005). In the clinical setting, spasticity is assessed as a velocity-dependent increased resistance to passive muscle stretch (Gorter, Verschuren, van Riel, & Ketelaar, 2009).…”

Section: Introductionmentioning

confidence: 99%

The effect of vibration therapy on spasticity and motor function in children with cerebral palsy: A randomized controlled trial

Katušić¹,

Alimović²,

Mejaški-Bošnjak

2013

NRE

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As the motor system relies heavily on deep sensory stimulation, recent studies have investigated the effect of vibration stimuli. Although research suggests a positive influence of vibration on motor performance in individuals with neurological disorders, there are very limited numbers of studies in children with cerebral palsy (CP). The objective of the present study was to evaluate the effects of sound wave vibration therapy on spasticity and motor function in children with CP. In this 3-month trial, 89 children with spastic CP were randomized to either continue their physiotherapy treatment (PT) or to receive vibration therapy twice a week in addition to their PT program. The randomization was stratified according to the Gross Motor Function Classification System (GMFCS) level to ensure similar functional ability. Children were assessed at baseline and after the 12-week intervention period. The outcomes measured were spasticity level as assessed by Modified Modified Ashworth Scale (MMAS) and gross motor function as assessed by Gross Motor Function Measurement (GMFM-88). Subgroup analysis was performed for the GMFCS. Significant differences between groups were detected for changes in spasticity level and gross motor function after the three months intervention.In conclusion, vibration therapy may decrease spasticity and improve motor performance in children with CP. The results of the present trial serve as valuable input for evidence-based treatments in paediatric neurorehabilitation.

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The relationship between spasticity in young children (18 months of age) with cerebral palsy and their gross motor function development

Cited by 40 publications

References 29 publications

Functional capacity and assistance from the caregiver during daily activities in Brazilian children with cerebral palsy

Functional capacity and assistance from the caregiver during daily activities in Brazilian children with cerebral palsy

Interobserver reliability of the Australian Spasticity Assessment Scale (ASAS)

The effect of vibration therapy on spasticity and motor function in children with cerebral palsy: A randomized controlled trial

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