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[Clinical assessment of spasticity in children]
I Hodgkinson1, J-P Vadot, C Bérard
1Médecine Physique et Réadaptation Pédiatrique, L'Escale, Centre Hospitalier Lyon-Sud, Pierre-Bénite. isabelle.hodgkinson@chu-lyon.fr
Insights
This study highlights key assessment steps for children with cerebral palsy (CP). It emphasizes using observational, analytical, and functional measures, like the Ashworth and Tardieu scales, for comprehensive CP evaluation.
Area of Science:
- Pediatrics
- Neurology
- Rehabilitation Medicine
Context:
- Cerebral palsy (CP) assessment requires a multifaceted approach.
- Functional impairments in CP stem from muscle weakness and spasticity.
- Accurate assessment is crucial for effective intervention and outcome tracking.
Purpose:
- To outline the four principal steps in assessing children with cerebral palsy (CP).
- To compare the analytical assessments of spasticity using the Ashworth and Tardieu scales.
- To underscore the importance of functional and joint assessments in CP management.
Summary:
- Observational assessment identifies muscle weakness, spasticity, and functional impairment in CP.
- The Ashworth and Tardieu scales offer complementary insights into spasticity.
- The Gross Motor Function Measure (GMFM) is a validated, CP-specific tool for outcome evaluation and monitoring.
- Joint assessment is vital for detecting muscle contractures.
Impact:
- Provides a structured framework for assessing children with CP.
- Informs clinical practice by comparing spasticity assessment tools.
- Highlights the utility of the GMFM for tracking progress in CP.
- Emphasizes the necessity of a multidisciplinary team approach for holistic CP care.
Abstract:
This article presents the four principle steps of assessment of children with cerebral palsy. Weakness of some muscles groups and spasticity of others and the subsequent functional impairment can be identified by observation. Analytical assessments of spasticity with the Ashworth and Tardieu scales were compared in 30 children with cerebral palsy, mean age 8.5 years. The results pointed out the complimentary nature of these two scales: The Gross Motor Function Measure, which is a validated scale, is specific for children with cerebral palsy. This measure provides a useful assessment of outcome and a convenient means of evaluating the time-course. Joint assessment is also essential to identify muscle contracture. Assessment of spasticity in children with cerebral palsy must be conducted by a multidisciplinary team to take into account all the aspects involved.