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Burke–Fahn–Marsden dystonia severity, Gross Motor, Manual Ability, and Communication Function Classification scales in childhood hyperkinetic movement disorders including cerebral palsy: a ‘Rosetta Stone’ study
Author(s) -
Elze Markus C,
Gimeno Hortensia,
Tustin Kylee,
Baker Lesley,
Lumsden Daniel E,
Hutton Jane L,
Lin JeanPierre SM
Publication year - 2016
Publication title -
developmental medicine and child neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.658
H-Index - 143
eISSN - 1469-8749
pISSN - 0012-1622
DOI - 10.1111/dmcn.12965
Subject(s) - dystonia , cerebral palsy , gross motor function classification system , movement disorders , psychology , rating scale , physical medicine and rehabilitation , functional movement , concordance , audiology , developmental psychology , medicine , neuroscience , disease
Aim Hyperkinetic movement disorders ( HMD s) can be assessed using impairment‐based scales or functional classifications. The Burke–Fahn–Marsden Dystonia Rating Scale‐movement ( BFM ‐M) evaluates dystonia impairment, but may not reflect functional ability. The Gross Motor Function Classification System ( GMFCS ), Manual Ability Classification System ( MACS ), and Communication Function Classification System ( CFCS ) are widely used in the literature on cerebral palsy to classify functional ability, but not in childhood movement disorders. We explore the concordance of these three functional scales in a large sample of paediatric HMD s and the impact of dystonia severity on these scales. Method Children with HMD s ( n =161; median age 10y 3mo, range 2y 6mo–21y) were assessed using the BFM ‐M, GMFCS , MACS , and CFCS from 2007 to 2013. This cross‐sectional study contrasts the information provided by these scales. Results All four scales were strongly associated (all Spearman's rank correlation coefficient r s >0.72, p <0.001), with worse dystonia severity implying worse function. Secondary dystonias had worse dystonia and less function than primary dystonias ( p <0.001). A longer proportion of life lived with dystonia is associated with more severe dystonia ( r s =0.42, p <0.001). Interpretation The BFM ‐M is strongly linked with the GMFCS , MACS , and CFCS , irrespective of aetiology. Each scale offers interrelated but complementary information and is applicable to all aetiologies. Movement disorders including cerebral palsy can be effectively evaluated using these scales.