Determinants of gait dystonia severity in cerebral palsy

Aim To determine the movement features governing expert assessment of gait dystonia severity in individuals with cerebral palsy (CP). Method In this prospective cohort study, three movement disorder neurologists graded lower extremity dystonia severity in gait videos of individuals with CP using a 1...

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Bibliographic Details
Published in:Developmental medicine and child neurology 2023-07, Vol.65 (7), p.968-977
Main Authors: Aravamuthan, Bhooma R., Pearson, Toni S., Ueda, Keisuke, Miao, Hanyang, Zerafati‐Jahromi, Gazelle, Gilbert, Laura, Comella, Cynthia, Perlmutter, Joel S.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Biomechanical Phenomena
Cerebral Palsy - complications
Cerebral Palsy - diagnosis
Child
Dystonia - diagnosis
Dystonia - etiology
Dystonic Disorders
Female
Gait
Humans
Male
Movement Disorders
Prospective Studies
Young Adult
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Summary:Aim To determine the movement features governing expert assessment of gait dystonia severity in individuals with cerebral palsy (CP). Method In this prospective cohort study, three movement disorder neurologists graded lower extremity dystonia severity in gait videos of individuals with CP using a 10‐point Likert‐like scale. Using conventional content analysis, we determined the features experts cited when grading dystonia severity. Then, using open‐source pose estimation techniques, we determined gait variable analogs of these expert‐cited features correlating with their assessments of dystonia severity. Results Experts assessed videos from 116 participants (46 with dystonia aged 15 years [SD 3] and 70 without dystonia aged 15 years [SD 2], both groups ranging 10–20 years old and 50% male). Variable limb adduction was most commonly cited by experts when identifying dystonia, comprising 60% of expert statements. Effect on gait (regularity, stability, trajectory, speed) and dystonia amplitude were common features experts used to determine dystonia severity, comprising 19% and 13% of statements respectively. Gait variables assessing adduction variability and amplitude (inter‐ankle distance variance and foot adduction amplitude) were significantly correlated with expert assessment of dystonia severity (multiple linear regression, p 
ISSN:0012-1622
1469-8749
1469-8749
DOI:10.1111/dmcn.15524