‘Toning’ up hypotonia assessment: A proposal and critique

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 p...

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Main Authors: Pragashnie Govender (nee' Naidoo), Robin W.E. Joubert
Format: Article
Language:English
Published: AOSIS 2016-05-01
Series:African Journal of Disability
Subjects:
Online Access:https://ajod.org/index.php/ajod/article/view/231
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author Pragashnie Govender (nee' Naidoo)
Robin W.E. Joubert
author_facet Pragashnie Govender (nee' Naidoo)
Robin W.E. Joubert
author_sort Pragashnie Govender (nee' Naidoo)
collection DOAJ
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 praxis Keywords: hypotonia; low muscle tone; clinical algorithm; clinical assessment
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spelling doaj.art-5e670185ac014669a1abef9129e42a1e2022-12-22T03:01:53ZengAOSISAfrican Journal of Disability2223-91702226-72202016-05-0151e1e910.4102/ajod.v5i1.23181‘Toning’ up hypotonia assessment: A proposal and critiquePragashnie Govender (nee' Naidoo)0Robin W.E. Joubert1Discipline of Occupational Therapy, School of Health Sciences, University of KwaZulu-NatalDiscipline of Occupational Therapy, School of Health Sciences, University of KwaZulu-NatalBackground: 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 praxis Keywords: hypotonia; low muscle tone; clinical algorithm; clinical assessmenthttps://ajod.org/index.php/ajod/article/view/231hypotonialow muscle toneclinical algorithmclinical assessment
spellingShingle Pragashnie Govender (nee' Naidoo)
Robin W.E. Joubert
‘Toning’ up hypotonia assessment: A proposal and critique
African Journal of Disability
hypotonia
low muscle tone
clinical algorithm
clinical assessment
title ‘Toning’ up hypotonia assessment: A proposal and critique
title_full ‘Toning’ up hypotonia assessment: A proposal and critique
title_fullStr ‘Toning’ up hypotonia assessment: A proposal and critique
title_full_unstemmed ‘Toning’ up hypotonia assessment: A proposal and critique
title_short ‘Toning’ up hypotonia assessment: A proposal and critique
title_sort toning up hypotonia assessment a proposal and critique
topic hypotonia
low muscle tone
clinical algorithm
clinical assessment
url https://ajod.org/index.php/ajod/article/view/231
work_keys_str_mv AT pragashniegovenderneenaidoo toninguphypotoniaassessmentaproposalandcritique
AT robinwejoubert toninguphypotoniaassessmentaproposalandcritique