Validation of a care and comfort hypertonicity questionnaire

Robin Nemer McCoy, Peter Blasco, Barry S. Russman, Jean P. O'Malley

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

The lack of evidence regarding functional and quality of life benefits resulting from tone reduction with intrathecal baclofen (ITB) infusion treatment relates to the lack of validated and responsive measures. We integrated our scale/questionnaire, developed from chart review, with the non-validated Caregiver Questionnaire (CQ) to yield a final document, the Care and Comfort Hypertonicity Questionnaire (CCHQ). Convergent validity was achieved by administering the CCHQ to 47 patients with spastic/dystonic cerebral palsy (CP) who were being evaluated for tone management. The population studied included 18 females and 29 males (mean age 10y [SD 4y 10mo]; range 3y 1mo - 21y 1mo). Twenty-five patients were subsequently referred for botulinum toxin (BTX-A) injections (mean Gross Motor Function Classification System [GMFCS] 3.2); 11 patients were referred for ITB (mean GMFCS 4.4); four were referred for orthopedic surgery (mean GMFCS 3.3); 3 were referred for selective dorsal rhizotomy (mean GMFCS 2.7); one was recommended for oral baclofen (GMFCS 5); and three were recommended for no treatment (mean GMFCS 3.7). Blinded to the score, those with the highest scores (severe hypertonicity) were recommended for ITB; those with the lowest scores were recommended for BTX-A injections. Responsiveness of the CCHQ was established by administering the questionnaire to patients who already had an implanted ITB pump. The children with the largest dose increase demonstrated a statistically significant improvement in the CCHQ score. This scale can be used to document the efficacy of treating severe hypertonicity both in clinical and research protocols.

Original languageEnglish (US)
Pages (from-to)181-187
Number of pages7
JournalDevelopmental Medicine and Child Neurology
Volume48
Issue number3
DOIs
StatePublished - Mar 2006

Fingerprint

Baclofen
Rhizotomy
Type A Botulinum Toxins
Injections
Cerebral Palsy
Clinical Protocols
Patient Comfort
Surveys and Questionnaires
Caregivers
Orthopedics
Quality of Life
Therapeutics
Population

ASJC Scopus subject areas

  • Clinical Neurology
  • Pediatrics, Perinatology, and Child Health
  • Neuroscience(all)

Cite this

Validation of a care and comfort hypertonicity questionnaire. / McCoy, Robin Nemer; Blasco, Peter; Russman, Barry S.; O'Malley, Jean P.

In: Developmental Medicine and Child Neurology, Vol. 48, No. 3, 03.2006, p. 181-187.

Research output: Contribution to journalArticle

McCoy, Robin Nemer ; Blasco, Peter ; Russman, Barry S. ; O'Malley, Jean P. / Validation of a care and comfort hypertonicity questionnaire. In: Developmental Medicine and Child Neurology. 2006 ; Vol. 48, No. 3. pp. 181-187.
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