Velocity dependent measure of spasticity: Reliability in children and juveniles with neuromotor disorders
Petra Marsico1,2,3, Victoria Frontzek-Weps1,2,4, Hubertus J A van Hedel1,2,3
1Research Department, Swiss Children's Rehab, University Children's Hospital Zurich, Affoltern am Albis, Switzerland.
Insights
The Velocity Dependent Measure of Spasticity (VDMS) is a reliable new test for rating spasticity in children with neuromotor disorders. This standardized assessment accurately measures spasticity severity in limbs.
Area of Science:
- Neurology
- Pediatrics
- Rehabilitation Medicine
Background:
- Spasticity is a common motor disorder in children with neuromotor impairments.
- Accurate and reliable assessment of spasticity is crucial for effective treatment planning and monitoring.
- Existing spasticity measures may lack standardization or comprehensive evaluation.
Purpose of the Study:
- To develop and validate the Velocity Dependent Measure of Spasticity (VDMS), a standardized test for rating spasticity severity.
- To categorize spasticity into four levels based on Lance's definition.
- To establish the reliability of the VDMS in a pediatric population.
Main Methods:
- Evaluated upper and lower limb muscle groups in children with neuromotor disorders.
- Assessed responses to passive movement under fast- and slow-velocity conditions.
- Determined interrater and test-retest reliability using Gwet's alpha and percentage agreement.
Main Results:
- The VDMS demonstrated substantial to almost perfect interrater reliability (Gwet's alpha: 0.66-0.99) among 45 children and youths.
- Test-retest reliability was also found to be almost perfect (Gwet's alpha: 0.83-1.00) in 42 participants.
- The assessment involved two independent physiotherapists evaluating 45 children aged 4-19 years.
Conclusions:
- The Velocity Dependent Measure of Spasticity (VDMS) is a reliable assessment tool.
- The VDMS offers a standardized procedure for evaluating spasticity in pediatric neuromotor disorders.
- This measure can aid clinicians in accurately assessing and managing spasticity in children's extremities.
Purpose:
The purpose of this study was to create a clear, standardized test description to rate spasticity severity into four categories according to the definition given by Lance [1], referred to as the Velocity Dependent Measure of Spasticity (VDMS).
Method:
Muscle groups of the upper and lower limbs of children with neuromotor disorders were evaluated on their response to passive movement in a fast-versus slow-velocity test condition. The interrater and test-retest reliability were assessed using Gwet's alpha one (95%-CI) and the percentage agreement.
Results:
Two physiotherapists independently assessed 45 children and youths (age 4-19 years). The interrater reliability of the VDMS was substantial to almost perfect (Gwet's alpha one: 0.66-0.99, n= 45) while the test-retest reliability was almost perfect as well (Gwet's alpha one: 0.83-1.00, n= 42).
Conclusion:
The VDMS can be recommended as a reliable assessment with a standardized procedure to assess spasticity of the extremities in children with neuromotor disorders.
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