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In this study, we investigated whether (1) children with cerebral palsy (CP) using night orthoses experience more sleep disturbance than those not using night orthoses, (2) parental personality is related to the experienced parental burden of night orthoses, and (3) parental sense of competence in the parenting role mediates the relation between parental personality and parental burden. Eighty-two Flemish children with CP (55 using/27 not using night orthoses) with a mean age of 9 years and 10 months (GMFCS level I-V) participated in this cross-sectional questionnaire study, using the Sleep Disturbance Scale (SDSC), Parenting Stress Index (PSI), Big Five Inventory (BFI) and a newly developed inventory to assess the parental burden of night orthoses. Multivariate analysis of covariance revealed no statistical significant differences in sleep disturbance between children using/not using night orthoses. These findings are positive as the use of night orthoses are presumed to be important in providing adequate postural care in children with CP. Extraverted and emotionally stable parents experienced less parental burden. Mediation analysis revealed that parental sense of competence partially mediated the relation between parental personality and the parental burden. These results suggest that integrating parental sense of competence in treatment programs can improve the understanding of experienced burden. Implications of such integrations for therapy are discussed. (Contains 2 figures and 4 tables.)

Aim: This study investigated the reliability and validity of the Barry-Albright Dystonia Scale (BADS), the Burke-Fahn-Marsden Movement Scale (BFMMS), and the Unified Dystonia Rating Scale (UDRS) in patients with bilateral dystonic cerebral palsy (CP). Method: Three raters independently scored videotapes of 10 patients (five males, five females; mean age 13y 3mo, SD 5y 2mo, range 5-22y). One patient each was classified at levels I-IV in the Gross Motor Function Classification System and six patients were classified at level V. Reliability was measured by (1) intraclass correlation coefficient (ICC) for interrater reliability, (2) standard error of measurement (SEM) and smallest detectable difference (SDD), and (3) Cronbach's alpha for internal consistency. Validity was assessed by Pearson's correlations among the three scales used and by content analysis. Results: Moderate to good interrater reliability was found for total scores of the three scales (ICC: BADS = 0.87; BFMMS = 0.86; UDRS = 0.79). However, many subitems showed low reliability, in particular for the UDRS. SEM and SDD were respectively 6.36% and 17.72% for the BADS, 9.88% and 27.39% for the BFMMS, and 8.89% and 24.63% for the UDRS. High internal consistency was found. Pearson's correlations were high. Content validity showed insufficient accordance with the new CP definition and classification. Interpretation: Our results support the internal consistency and concurrent validity of the scales; however, taking into consideration the limitations in reliability, including the large SDD values and the content validity, further research on methods of assessment of dystonia is warranted.

Aim: The aim of this study was to examine the reliability and validity of the Dyskinesia Impairment Scale (DIS). The DIS consists of two subscales: dystonia and choreoathetosis. It measures both phenomena in dyskinetic cerebral palsy (CP).Method: Twenty-five participants with dyskinetic CP (17 males; eight females; age range 5–22y; mean age 13y 6mo; SD 5y 4mo), recruited from special schools for children with motor disorders, were included. Exclusion criteria were changes in muscle relaxant medication within the previous 3 months, orthopaedic or neurosurgical interventions within the previous year, and spinal fusion. Interrater reliability was verified by two independent raters. For interrater reliability, intraclass correlation coefficients were assessed. Standard error of measurement, the minimal detectable difference, and Cronbach’s alpha for internal consistency were determined. For concurrent validity of the DIS dystonia subscale, the Barry–Albright Dystonia Scale was administered.Results: The intraclass correlation coefficient for the total DIS score and the two subscales ranged between 0.91 and 0.98 for interrater reliability. The reliability of the choreoathetosis subscale was found to be higher than that of the dystonia subscale. The standard error of the measurement and minimal detectable difference values were adequate. Cronbach’s alpha values ranged from 0.89 to 0.93. Pearson’s correlation between the dystonia subscale and Barry–Albright Dystonia Scale was 0.84 (p<0.001).Interpretation: Good to excellent reliability and validity were found for the DIS. The DIS may be promising for increasing insights into the natural history of dyskinetic CP and evaluating interventions. Future research on the responsiveness of the DIS is warranted. [ABSTRACT FROM AUTHOR]