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

Published online by Cambridge University Press:  19 December 2005

Vanessa AB Scholtes
Affiliation:
Department of Rehabilitation Medicine, VU University Medical Centre, Amsterdam, the Netherlands.
Jules G Becher
Affiliation:
Department of Rehabilitation Medicine, VU University Medical Centre, Amsterdam, the Netherlands.
Anita Beelen
Affiliation:
Department of Rehabilitation, Academic Medical Centre, the Netherlands.
Gustaaf J Lankhorst
Affiliation:
Department of Rehabilitation Medicine, VU University Medical Centre, Amsterdam, the Netherlands.
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Abstract

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 assessment instruments were identified and evaluated using predetermined criteria. This review consists of reports on the standardization applied for assessment at different velocities, testing posture, and quantification of spasticity. Results show that most instruments do not comply with the concept of spasticity; standardization of assessment method is often lacking, and scoring systems of most instruments are ambiguous. Only the Tardieu Scale complies with the concept of spasticity, but this instrument has a comprehensive and time-consuming clinical scoring system.

Type
Review
Copyright
© 2006 Mac Keith Press

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