Familiarity with Hereditary Spastic Paraplegia (HSP) and Differentiation of Upper Body Gait Characteristics between Children with HSP and Spastic Diplegic Cerebral Palsy

Abstract

Aims

The aim of this two-part, prospective study was to determine therapist familiarity with HSP and examine diagnostic accuracy between individuals with HSP and those with Spastic Diplegic Cerebral Palsy (SD-CP).

Methods

Part-one surveyed physical therapists (PT) and physical therapist assistants (PTA) throughout Texas to determine familiarity with HSP and its gait deviations. Part-two examined accuracy in differential diagnosis of HSP versus SD-CP using gait analysis and the effects of an educational module on upper body gait deviations observed in individuals with HSP.

Results

Both PTs and PTAs indicated a high degree (≥73.2%) of unfamiliarity with HSP. While a majority of respondents (≥88.7%) indicated use of observational gait analysis in clinical practice, ≥92.5% indicated never receiving instruction on HSP or its associated gait deviations. Whole group analysis revealed diagnostic accuracy increased 21.7% post educational module. In addition, individual case diagnostic accuracy yielded significant improvement in 14 out of 20 cases.

Conclusions

Physical and occupational therapists are in a unique position to assist with the identification and distinction of HSP from CP. This study demonstrated that brief instruction on common upper body gait deviations seen in individuals with HSP may improve a clinician’s ability to distinguish SD-CP from HSP via gait analysis.

Keywords:

• Cerebral palsy
• gait analysis
• hereditary spastic paraplegia
• spastic paraparesis

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Notes on contributors

Christina Bickley

Christina Bickley, PT, PhD, BOCO, C/NDT is an Assistant Professor at Texas Woman’s University in Houston, Texas and a motion analysis therapist at Shriners Hospitals for Children in Houston, Texas.

Katy Mitchell

Katy Mitchell, PT, PhD is a Professor and Coordinator of the Doctorate Program at Texas Woman’s University in Houston, Texas.

Allison Scott

Allison Scott, MD is an Orthopedic Surgeon and Director of the HSP Clinic at Shriners Hospitals for Children in Houston, Texas.

Meredith Bury

Meredith Bury, PT, DPT is a Physical Therapist at Elite Physical Therapy in Graham, Washington.

Mayowa Oyelami

Mayowa Oyelami, PT, DPT is a Physical Therapist and Neurological Resident at Harris Health System in Houston, Texas.