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Last updated: 02 January 2025 Print

Measures for Hypertonia, Ataxia, and Tics

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Outcome measuresScales and Measures

General Hypertonia Assessment Tools

  • Hypertonia Assessment Tool (HAT): Differentiates between spasticity, dystonia, and rigidity in children.
  • Modified Tardieu Scale (MTS): Evaluates velocity-dependent hypertonia and distinguishes spasticity from contractures.
  • Modified Ashworth Scale (MAS): Grades spasticity severity on a 0–4 scale.
  • Tone Assessment Scale (TAS): Measures tone in different postures and its functional impact.

Spasticity-Specific Tools

  • Pendulum Test: Measures the oscillatory movement of a limb to assess spasticity.
  • Electrophysiological Measures:
    • H-reflex to M-wave Ratio (H/M ratio): Quantifies reflex hyperexcitability in spasticity.
    • Composite Spasticity Index (CSI): Combines clinical and electrophysiological measures for spasticity evaluation.

Dystonia-Specific Tools

  • Barry-Albright Dystonia Scale (BADS): Rates dystonia severity in children with cerebral palsy.
  • Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS): Measures severity and disability caused by dystonia.
  • Unified Dystonia Rating Scale (UDRS): Comprehensive assessment of dystonia in multiple body parts.

Ataxia-Specific Tools

  • Scale for the Assessment and Rating of Ataxia (SARA): Rates severity of ataxia across domains like gait, stance, and coordination.
  • International Cooperative Ataxia Rating Scale (ICARS): Assesses postural control, coordination, speech, and oculomotor function.
  • Brief Ataxia Rating Scale (BARS): Focuses on critical aspects of ataxia for quicker assessments.
  • Friedreich Ataxia Rating Scale (FARS): Specific to Friedreich’s ataxia but applicable to other types.
  • Nine-Hole Peg Test (9HPT): Measures upper limb coordination.
  • Dynamic Gait Index (DGI): Evaluates gait adaptability in ataxic individuals.
  • Berg Balance Scale (BBS): Assesses balance in patients with ataxia.

Tic-Specific Tools

  • Yale Global Tic Severity Scale (YGTSS): Comprehensive scale assessing tic severity, impairment, and frequency.
  • Shapiro Tourette Syndrome Severity Scale (STSSS): Evaluates the severity of motor and vocal tics.
  • Premonitory Urge for Tics Scale (PUTS): Measures the intensity of premonitory urges associated with tics.
  • Tourette Syndrome Symptom List (TSSL): Provides a checklist of motor and vocal tics for clinical evaluation.
  • Child Tourette Syndrome Impairment Scale (CTIM): Focuses on how tics affect daily life and functioning.
  • Modified Rush Video Rating Scale (MRVRS): Uses video recordings to rate tic severity and frequency.
  • Tic Inventory Checklist: Assesses the variety and complexity of tics observed.

Functional and Quality of Life Measures

  • Pediatric Quality of Life Inventory (PedsQL): Evaluates the impact of hypertonia, ataxia, or tics on life quality.
  • Cerebral Palsy Quality of Life (CP QOL): Measures emotional and social impact specific to hypertonia.
  • Child Behavior Checklist (CBCL): Useful for identifying behavioral and social issues in children with tics.

Pain and Discomfort Scales

  • Visual Analog Scale (VAS): Assesses pain associated with hypertonia or tics.
  • FLACC Scale (Face, Legs, Activity, Cry, Consolability): Pain assessment for non-verbal children.

Monitoring and Outcome Measures

  • Goal Attainment Scaling (GAS): Tracks individual treatment goals in hypertonia, ataxia, or tic disorders.
  • Canadian Occupational Performance Measure (COPM): Monitors progress in functional and daily life activities.
  • YGTSS or MRVRS: Can be used longitudinally to assess tic disorder management outcomes.

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