‘Toning’ up hypotonia assessment: A proposal and critique

African Journal of Disability

 
 
Field Value
 
Title ‘Toning’ up hypotonia assessment: A proposal and critique
 
Creator Govender (nee' Naidoo), Pragashnie Joubert, Robin W.E.
 
Subject paediatrics; occupational therapy; physiotherapy hypotonia; low muscle tone; clinical algorithm; clinical assessment
Description Background: Clinical assessment of hypotonia is challenging due to the subjective nature of the initial clinical evaluation. This poses dilemmas for practitioners in gaining accuracy, given that the presentation of hypotonia can be either a non-threatening or malevolent sign. The research question posed was how clinical assessment can be improved, given the current contentions expressed in the scientific literature.Objectives: This paper describes the development and critique of a clinical algorithm to aid the assessment of hypotonia.Methods: An initial exploratory sequential phase, consisting of a systematic review, a survey amongst clinicians and a Delphi process, assisted in the development of the algorithm, which is presented within the framework of the International Classification of Functioning, Disability and Health. The ensuing critique followed a qualitative emergent–systematic focus group design with a purposive sample of 59 clinicians. Data were analysed using semantical content analysis and are presented thematically with analytical considerations.Results: This study culminated in the development of an evidence-based clinical algorithm for practice. The qualitative critique of the algorithm considered aspects such as inadequacies, misconceptions and omissions; strengths; clinical use; resource implications; and recommendations.Conclusions: The first prototype and critique of a clinical algorithm to assist the clinical assessment of hypotonia in children has been described. Barriers highlighted include aspects related to knowledge gaps of clinicians, issues around user-friendliness and formatting concerns. Strengths identified by the critique included aspects related to the evidence-based nature of the criteria within the algorithm, the suitability of the algorithm in being merged or extending current practice, the potential of the algorithm in aiding more accurate decision-making, the suitability of the algorithm across age groups and the logical flow. These findings provide a starting point towards ascertaining the clinical utility of the algorithm as an essential step towards evidence-based praxisKeywords: hypotonia; low muscle tone; clinical algorithm; clinical assessment
 
Publisher AOSIS
 
Contributor Medical Research Council National Research Foundation
Date 2016-05-26
 
Type info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion — advanced mixed methods study
Format text/html application/octet-stream text/xml application/pdf
Identifier 10.4102/ajod.v5i1.231
 
Source African Journal of Disability; Vol 5, No 1 (2016); 9 pages 2226-7220 2223-9170
 
Language eng
 
Relation
The following web links (URLs) may trigger a file download or direct you to an alternative webpage to gain access to a publication file format of the published article:

https://ajod.org/index.php/ajod/article/view/231/433 https://ajod.org/index.php/ajod/article/view/231/434 https://ajod.org/index.php/ajod/article/view/231/435 https://ajod.org/index.php/ajod/article/view/231/417
 
Coverage Africa and Globally — infants and children
Rights Copyright (c) 2016 Pragashnie Govender (nee' Naidoo), Robin W.E. Joubert https://creativecommons.org/licenses/by/4.0
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