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Category: Volume 06 Issue 09 September 2018
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Title: Hip Adductor Spasticity Scales and Walking Base of Support in Children with Cerebral Palsy

Authors: Abhimanyu Vasudeva, Nonica Laisram, Asem Rangita Chanu

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i9.155

Abstract

Hip Adductor spasticity causes gait impairment in Cerebral Palsy (CP). Adductor Tone Rating Scale (ATRS) and Visual Method by vertical suspension are methods of grading this spasticity. The objective of our study was to study whether ATRS or Visual Method correlates better with walking Base of Support in CP children. It was an interventional cohort study in the outpatient clinic of Department of Physical Medicine and Rehabilitation in a Tertiary hospital. A total of 31 CP children with lower limb spasticity walking independently were enrolled. Botulinum toxin A was injected to gastrocnemius and hamstring with spasticity of Modified Ashworth Scale ≥ 2 and/or Hip Adductors with ATRS ≥ 2 and evaluated for various outcome measures before injection and at 4 and 12 weeks follow-up. Spearman’s correlation analysis was performed between the walking base of support and each of ATRS and Visual Method. The main outcome measurements were ATRS and Visual Method for hip adductor spasticity, and walking base of support. Statistically significant reduction was seen after injection on ATRS and the Visual Method at 4 weeks and at 12 weeks compared with baseline. Significant improvement was seen in base of support of children with and without injection at 4 weeks ((p value = 0.011 and 0.008) and at 12 weeks (p value = 0.011and 0.007) compared with baseline. In the injected group, base of support had statistically significant correlation with Visual Method in contrast to ATRS at 4 weeks (p value = 0.0019 and 0.0918) and at 12 weeks (p value = 0.0008 and 0.6532). In non- injected group also, base of support had statistically significant correlation with Visual Method in contrast to ATRS at baseline and all follow – ups. To conclude, the Visual Method shows a better correlation than ATRS with walking base of support in CP children with lower limb spasticity.

Keywords: Cerebral Palsy, Spasticity, Gait, Botulinum toxin.

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Corresponding Author

Abhimanyu Vasudeva

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