Clinical Presentation of Spasticity and Passive Range of Motion Deviations in Dyskinetic Cerebral Palsy in Relation to Dystonia, Choreoathetosis, and Functional Classification Systems

ABSTRACT

Objectives: To map the presence, severity, and distribution of spasticity and passive range of motion (pROM) deviations in dyskinetic cerebral palsy (DCP), and to explore their relation with dystonia, choreoathetosis, and functional abilities.

Methods: This cross-sectional study included 53 participants with DCP. Spasticity was assessed with the Modified Ashworth Scale, limited- and increased pROM (hypermobility) with a goniometer, dystonia and choreoathetosis with the Dyskinesia Impairment Scale, gross motor and manual abilities with corresponding functional classification systems.

Results: Spasticity and limited pROM were correlated with dystonia of the upper limbs (0.41< r_s<0.47, <0.001 < p < .002) and lower limbs (0.31< r_s<0.41, 0.002 < p < .025), and both functional systems of gross motor (0.32< r_s<0.51, <0.001 < p < .018) and fine manual abilities (0.34< r_s<0.44, 0.001 < p < .014). Hypermobility is correlated only with choreoathetosis of the lower limbs (0.44, p = .001).

Conclusions: Coexisting spasticity and pROM deviations in DCP are functionally limiting and should be addressed accordingly. Hypermobility may lead to an increased luxation risk.

KEYWORDS:

• Cerebral palsy
• spasticity
• dystonia
• choreoathetosis
• passive range of motion
• functional classification system

Acknowledgments

We thank all participants and their parents for their willingness to participate in this study. A wholehearted gratitude to the Committee of Flemish Motor Disability Centers (KOMPAS) and clinicians for their time and invaluable help.

Declaration Of Interest

The authors report no conflicts of interest.

Additional information

Funding

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.