TY - JOUR
T1 - Gait features of dystonia in cerebral palsy
AU - Aravamuthan, Bhooma R.
AU - Ueda, Keisuke
AU - Miao, Hanyang
AU - Gilbert, Laura
AU - Smith, Sarah E.
AU - Pearson, Toni S.
N1 - Funding Information:
BRA receives research funding from the National Institute of Neurological Disorders and Stroke. TSP receives research funding from the National Institute of Neurological Disorders and Stroke and reports consulting fees from Teva Pharmaceuticals. KU, LG, HM, and SES report no disclosures. Funding supporting this work is from the National Institutes of Neurological Disorders and Stroke (5K12NS098482‐02). The authors have stated that they had no interests that might be perceived as posing conflict or bias.
Publisher Copyright:
© 2021 Mac Keith Press
PY - 2021/6
Y1 - 2021/6
N2 - Aim: To determine the features cited by motor phenotyping experts when identifying dystonia in people with cerebral palsy (CP). Method: Dystonia identification in CP, particularly when comorbid with spasticity, can be difficult. The dystonia diagnostic criterion standard remains subjective visual identification by expert consensus. For this qualitative study, we conducted an inductive thematic analysis of consensus-building discussions between three pediatric movement disorder physicians as they identified the presence or absence of dystonia in gait videos of 40 participants with spastic CP and periventricular leukomalacia. Results: Unanimous consensus about the presence or absence of dystonia was achieved for 34 out of 40 videos. Two main themes were present during consensus-building discussions as videos were evaluated for dystonia: (1) unilateral leg or foot adduction that was variable over time, and (2) difficulty in identifying dystonia. Codes contributing to the first theme were more likely to be cited by a discussant when they felt dystonia was present (as opposed to absent) in a video (χ2 test, p=0.004). Discussion: These results describe the gait features cited by experts during consensus-building discussion as they identify dystonia in ambulatory people with CP. Qualitative thematic analysis of these discussions could help codify the subjective process of dystonia diagnosis.
AB - Aim: To determine the features cited by motor phenotyping experts when identifying dystonia in people with cerebral palsy (CP). Method: Dystonia identification in CP, particularly when comorbid with spasticity, can be difficult. The dystonia diagnostic criterion standard remains subjective visual identification by expert consensus. For this qualitative study, we conducted an inductive thematic analysis of consensus-building discussions between three pediatric movement disorder physicians as they identified the presence or absence of dystonia in gait videos of 40 participants with spastic CP and periventricular leukomalacia. Results: Unanimous consensus about the presence or absence of dystonia was achieved for 34 out of 40 videos. Two main themes were present during consensus-building discussions as videos were evaluated for dystonia: (1) unilateral leg or foot adduction that was variable over time, and (2) difficulty in identifying dystonia. Codes contributing to the first theme were more likely to be cited by a discussant when they felt dystonia was present (as opposed to absent) in a video (χ2 test, p=0.004). Discussion: These results describe the gait features cited by experts during consensus-building discussion as they identify dystonia in ambulatory people with CP. Qualitative thematic analysis of these discussions could help codify the subjective process of dystonia diagnosis.
UR - http://www.scopus.com/inward/record.url?scp=85099064749&partnerID=8YFLogxK
U2 - 10.1111/dmcn.14802
DO - 10.1111/dmcn.14802
M3 - Article
C2 - 33411352
AN - SCOPUS:85099064749
SN - 0012-1622
VL - 63
SP - 748
EP - 754
JO - Developmental Medicine and Child Neurology
JF - Developmental Medicine and Child Neurology
IS - 6
ER -