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Hypotonia is a common trait in infants with Down syndrome, resulting in pathologies and delays in gaining basic motor skills. There are no screenings available to aid in early diagnosis, therefore, the purpose of this study is to develop a way to test for hypotonia in children with Down syndrome.
Hypotonia is usually diagnosed by observation and clinical assessment. Aiming to develop an instrument for early diagnosis, a systematic review was carried out which compiled characteristics and testing that are attributed to or used in the diagnosis of hypotonia. They were presented as an item group and a first stage was created and administered to 50 children with Down's Syndrome between the ages of 7 months to 8 years old. The study of the results showed which characteristics were really related to the convention and which were more affected by changing factors. Then a final scale was developed that met the expected requirements of validity and reliability.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Down Syndrome | Children with down syndrome |
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| Measure | Description | Time Frame |
|---|---|---|
| Quality assessment of items by homogeneity analysis. Statistical analysis was performed using the SPSS-21 program. | A study of homogeneity of the items was carried out to know if each item was measuring the same as the globality of the test. It was carried out by means of a reliability study of the statistics of each item compared to the total scale. | 1 month |
| Analysis of the reliability of the scale | Reliability was measured by Cronbach's alpha. An interclass and inter-judge correlation analysis was performed | 1 month |
| Content validity | It was done through expert judgment. It was reviewed by three physiotherapists with extensive experience in treating hypotonic children and those items directed to the orofacial complex were also agreed with an expert speech therapist. | 1 month |
| Empirical validity. | The correlation between the graduation of hypotonia derived from the scale and the observational diagnosis estimated by the evaluator was analyzed. An ANOVA test was used to compare both diagnostic assessments.extensive experience in treating hypotonic children and those items directed to the orofacial complex were also agreed with an expert speech therapist. | 1 month |
| Structural validity | Through an exploratory factor analysis. Factorial analysis was carried out using the FACTOR program. | In the process of analysis. 1 month to get results. |
| Measure | Description | Time Frame |
|---|---|---|
| Descriptive analysis of the scale | Analyzing the values of standard deviation, mean, bias and kurtosis. | 1 month |
| Frequency analysis of the items. | Frequency with which 0 (less hypotonia), 1 or 2 (greater hypotonia) each item of the scale has been scored. |
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Inclusion Criteria:
Exclusion Criteria:
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Down Syndrome
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| Name | Affiliation | Role |
|---|---|---|
| Mª Guadalupe de Santos Moreno, MSc PT | Unicersity of Murcia | Principal Investigator |
| Antonia Gómez Conesa, PhD PT | Unicersity of Murcia | Study Director |
| José Antonio López Pina, PhD | Unicersity of Murcia | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Murcia | Murcia | 30100 | Spain |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 16357683 | Background | Martin K, Inman J, Kirschner A, Deming K, Gumbel R, Voelker L. Characteristics of hypotonia in children: a consensus opinion of pediatric occupational and physical therapists. Pediatr Phys Ther. 2005 Winter;17(4):275-82. doi: 10.1097/01.pep.0000186506.48500.7c. | |
| 28730054 | Background | Govender P, Joubert RWE. 'Toning' up hypotonia assessment: A proposal and critique. Afr J Disabil. 2016 May 26;5(1):231. doi: 10.4102/ajod.v5i1.231. eCollection 2016. |
| Label | URL |
|---|---|
| The American Academy for Cerebral Palsy and Developmental Medicine, develops a care pathway for therapeutic interventions for central hypotonia | View source |
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| ID | Term |
|---|---|
| D009123 | Muscle Hypotonia |
| D004314 | Down Syndrome |
| C562515 | Congenital Hemidysplasia with Ichthyosiform Erythroderma and Limb Defects |
| ID | Term |
|---|---|
| D020879 | Neuromuscular Manifestations |
| D009461 | Neurologic Manifestations |
| D009422 | Nervous System Diseases |
| D012816 | Signs and Symptoms |
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| 1 month |
| Analysis of the scale items. | An analysis of standard deviation, mean, correlation and Cronbach's alpha was performed for each item that made up the scale. | 1 month |
| 29405265 | Background | Goo M, Tucker K, Johnston LM. Muscle tone assessments for children aged 0 to 12 years: a systematic review. Dev Med Child Neurol. 2018 Jul;60(7):660-671. doi: 10.1111/dmcn.13668. Epub 2018 Feb 6. |
| 17700351 | Background | Martin K, Kaltenmark T, Lewallen A, Smith C, Yoshida A. Clinical characteristics of hypotonia: a survey of pediatric physical and occupational therapists. Pediatr Phys Ther. 2007 Fall;19(3):217-26. doi: 10.1097/PEP.0b013e3180f62bb0. |
| 29853815 | Background | Govender P, Joubert RWE. Evidence-Based Clinical Algorithm for Hypotonia Assessment: To Pardon the Errs. Occup Ther Int. 2018 Apr 24;2018:8967572. doi: 10.1155/2018/8967572. eCollection 2018. |
| 23681830 | Background | Naidoo P, Joubert RW. Consensus on hypotonia via Delphi process. Indian J Pediatr. 2013 Aug;80(8):641-50. doi: 10.1007/s12098-013-1018-7. Epub 2013 May 17. |
| 23380578 | Background | Reus L, van Vlimmeren LA, Staal JB, Janssen AJ, Otten BJ, Pelzer BJ, Nijhuis-van der Sanden MW. Objective evaluation of muscle strength in infants with hypotonia and muscle weakness. Res Dev Disabil. 2013 Apr;34(4):1160-9. doi: 10.1016/j.ridd.2012.12.015. Epub 2013 Feb 1. |
| 25485571 | Background | Naidoo P. Development of an evidence-based clinical algorithm for practice in hypotonia assessment: a proposal. JMIR Res Protoc. 2014 Dec 5;3(4):e71. doi: 10.2196/resprot.3581. |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D008607 | Intellectual Disability |
| D019954 | Neurobehavioral Manifestations |
| D000015 | Abnormalities, Multiple |
| D000013 | Congenital Abnormalities |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |
| D025063 | Chromosome Disorders |
| D030342 | Genetic Diseases, Inborn |