Clinical assessment of spasticity in children with cerebral palsy: a critical review of available instruments

@article{Scholtes2005ClinicalAO,
  title={Clinical assessment of spasticity in children with cerebral palsy: a critical review of available instruments},
  author={V. A. Scholtes and Jules G. Becher and Anita Beelen and Gustaaf J. Lankhorst},
  journal={Developmental Medicine \& Child Neurology},
  year={2005},
  volume={48}
}
This study reviews the instruments used for the clinical assessment of spasticity in children with cerebral palsy, and evaluates their compliance with the concept of spasticity, defined as a velocity‐dependent increase in muscle tone to passive stretch. Searches were performed in Medline, Embase, and Cinahl, including the keywords ‘spasticity’, ‘child’, and‘cerebral palsy’, to identify articles in which a clinical method to measure spasticity was reported. Thirteen clinical spasticity… 
View on Wiley
onlinelibrary.wiley.com
223 Citations
Highly Influential Citations
12
Background Citations
55
Methods Citations
28
Results Citations
4

223 Citations

Comprehensive quantification of the spastic catch in children with cerebral palsy.

Assessment and Treatment of Spasticity in Children with Cerebral Palsy

Spastic cerebral palsy is the most common type of CP and management of spasticity involves multidisciplinary intervention intended to increase functionality, sustain health, and improve quality of life for children and their carers.

Evaluation of the catch in spasticity assessment in children with cerebral palsy.

Physiological responses during clinical spasticity evaluation in elbow flexors in children with cerebral palsy

The Tardieu test should be carried out with caution on individual level and more studies including kinematic and neuromuscular measures are necessary, because of the inconsistency in the results.

The development of spasticity with age in 4,162 children with cerebral palsy: a register-based prospective cohort study

The degree of spasticity of the gastrosoleus muscle often decreases after 5 years of age, which is important for long-term treatment planning and should be considered inSpasticity management.

Assessment of spasticity: an overview of systematic reviews

The findings suggest that, despite the decades of research, spasticity assessment still requires further investigation, with the majority of studies relying on methods that assess resistance to passive movement rather than spasticsity.

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

The findings indicate that when measured over one year, spasticity is marginally related to gross motor function development in infants with CP.

Velocity dependent measure of spasticity: Reliability in children and juveniles with neuromotor disorders.

The VDMS can be recommended as a reliable assessment with a standardized procedure to assess spasticity of the extremities in children with neuromotor disorders.

Use a Portable Device for Measuring Spasticity in Individuals with Cerebral Palsy

A strong negative correlation was found between moment-angle and the MAS in the evaluations of knee flexion and extension under conditions of fast and slow movement of both the right and left limbs, indicating that greater spasticity leads to a lower moment-angles.

Development of spasticity with age in a total population of children with cerebral palsy

In children with CP, the muscle tone as measured with the Ashworth scale increases up to 4 years of age and then decreases up to 12 years ofAge, the same tendency is seen in all spastic subtypes.
...

162 References

Objective measurement of clinical findings in the use of botulinum toxin type A for the management of children with cerebral palsy

The clinical protocol for patient selection and treatment used by the multidisciplinary team is presented, together with details of the assessment procedure.

Adductor spasticity in children with cerebral palsy and treatment with botulinum toxin type A: the parents' view of functional outcome

The parents' responses supported the impressions of the therapists, demonstrating that BTX‐A produced beneficial effects on daily activities, according to both objective measures and parents' observation.

Treatment of cerebral palsy with botulinum toxin: evaluation with gross motor function measure.

Improvements in spasticity, walking distance, and gross motor function were significantly greater in the BTA group than in the comparison group, and GMFM provides objective evidence regarding functional improvement after treatment in this patient population.

Measures of muscle and joint performance in the lower limb of children with cerebral palsy

Reliability of three lower‐limb clinical measures for children with cerebral palsy, the Modified Ashworth Scale of Spasticity, passive range of movement and the modified Tardieu scale were determined.

Spasticity in children with cerebral palsy: a retrospective review of the effects of intrathecal baclofen.

  • H. Wiens
  • Medicine, Psychology
    Issues in comprehensive pediatric nursing
  • 1998
Although intrathecal baclofen had a significant effect in reducing lower extremity spasticity in children with cerebral palsy, further prospective studies are needed to determine the effects of intratheCal bacl ofen on such indicators as activities of daily living.

Outcome measures of spasticity.

  • G. Johnson
  • Engineering
    European journal of neurology
  • 2002
While scales remain the most common method of measuring spasticity, there is considerable potential in instrumented techniques that can provide greater reliability and precision of measurement.

Functional Assessment Following Intrathecal Baclofen Therapy in Children With Spastic Cerebral Palsy

Outcomes of intrathecal baclofen therapy for 29 patients with cerebral palsy described, focusing on impairments, functional limitations, and disability, provide suggestive evidence that the combination of intrusion and rehabilitation has positive effects across the dimensions of disablement.

Open-Label Study of Botulinum Toxin for Upper Limb Spasticity in Cerebral Palsy

Botulinum toxin is useful in decreasing spasticity and improving the upper limb function of young children with cerebral palsy with normal cognition and Motivated families should be selected with a specific target of using botulinum toxins as an adjunct in a habilitation program.

Physical Management of Spasticity

Given the complexity in the standardized evaluation of children with spasticity, it is recommended that existing outcome measures or standardized scales be applied wherever possible as an adjunct tool to the clinician's assessment and interventions.

[Botulinum toxin in the management of spastic hip adductors in non-ambulatory cerebral palsy children].

This study demonstrates that the botulinum toxin can be effective against spasticity of the hip adductors and that its effect is still significant 6 months after the injection in more than half the hips treated and suggests that this treatment has a functional impact even in children with severe motor impairment.
...