Turkish Translation , Validity and Reliability of the Hypertonia Assessment Tool in Children With Motor Disorders

NCT ID: NCT07267442

Last Updated: 2025-12-05

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Total Enrollment

70 participants

Study Classification

OBSERVATIONAL

Study Start Date

2025-01-10

Study Completion Date

2026-06-10

Brief Summary

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Translating batteries with good psychometric properties into Turkish will increase the number of assessment batteries we can use in our language for clinical and academic studies. Therefore, the aim of our study was to verify the validity, reliability, and translation into Turkish of the Hypertonus Assessment Tool for children with motor disorders.

Detailed Description

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Among children with omotor disorders, particularly those with cerebral palsy, abnormalities in muscle tone are among the most common clinical symptoms. Damage occurring in various structures such as the thalamus, cerebral cortex, and basal ganglia can adversely affect muscle tone. Hypertonia is defined as an abnormal increase in resistance to externally imposed movement about a joint. It leads to limitations in activity participation, loss of motor control, and reduced quality of life. Hypertonia, which causes impairments in gross motor skills such as walking, stair climbing, and crawling, negatively affects the quality of life in childhood.

Muscle tone disorders in childhood can be classified into three main types: spasticity, dystonia, and rigidity. Spasticity is defined as a velocity-dependent increase in muscle tone associated with hyperexcitability of the tonic stretch reflex. Dystonia is a movement disorder characterized by sustained or intermittent involuntary muscle contractions that cause twisting, repetitive movements, abnormal postures, or a combination of these. Rigidity refers to bidirectional, velocity-independent resistance to passive movement, which may involve simultaneous co-contraction of agonist and antagonist muscles. In some cases, more than one type of tone abnormality may coexist.

Several assessment tools have been developed to evaluate different subtypes of hypertonia or general increases in tone. The most commonly used methods in clinical and research settings include the Modified Ashworth Scale (MAS), the Modified Tardieu Scale (MTS), and the Barry-Albright Dystonia Scale (BADS). While these scales evaluate different aspects of hypertonia, they do not distinguish between its subtypes. The Hypertonia Assessment Tool (HAT) was developed to address the need for a single instrument capable of differentiating among hypertonia subtypes. Introduced to the literature by Fehlings et al. in 2010, the HAT has been shown to be a valid and reliable tool for assessing the three subtypes of hypertonia in children with cerebral palsy.

The HAT involves observing an extremity joint during passive stretch and voluntary movement to detect increased tone or resistance. The scale consists of seven items-two assessing spasticity, two rigidity, and three dystonia. It can differentiate hypertonia subtypes in both upper and lower extremities and takes approximately five minutes to administer per limb. Studies in various patient populations have reported moderate to good levels of validity and reliability.

Translating psychometrically robust assessment tools into Turkish will expand the number of instruments available for clinical and research use in our native language. Therefore, the aim of this study was to translate the Hypertonia Assessment Tool into Turkish and to evaluate its validity and reliability in children with motor disorders.

Conditions

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Motor Disorder Reliability and Validity Hypertonia

Study Design

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Observational Model Type

OTHER

Study Time Perspective

CROSS_SECTIONAL

Study Groups

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Children with motor disorders

No interventions assigned to this group

Eligibility Criteria

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Inclusion Criteria

* as voluntary participation in the study,
* a diagnosis of a neuromotor disorder under the age of 18,
* sufficient cognitive ability to follow verbal commands

Exclusion Criteria

* Patients with any other systemic disease,
* Who had received botulinum toxin A injections or undergone surgery within the past three months,
* Be unable to follow verbal instructions
* Medical treatment had been modified within the last month
Maximum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Gazi University

OTHER

Sponsor Role collaborator

Kastamonu University

OTHER

Sponsor Role lead

Responsible Party

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Hidayet Cuha

Lecturer, PT, PhD(c)

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Bulent Elbasan, Prof. Dr.

Role: STUDY_CHAIR

Gazi University

Locations

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Gazi University

Ankara, , Turkey (Türkiye)

Site Status RECRUITING

Countries

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Turkey (Türkiye)

Central Contacts

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Hidayet Cuha, PhD(c)

Role: CONTACT

+90 534 646 01 06

Esra Serdaroglu, MD, Assoc. Prof.

Role: CONTACT

+90 312 202 6090

Facility Contacts

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Hidayet Cuha, PhD(c)

Role: primary

+90 534 646 01 06

References

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Marsico P, Frontzek-Weps V, Balzer J, van Hedel HJ. Hypertonia Assessment Tool. J Child Neurol. 2017 Jan;32(1):132-138. doi: 10.1177/0883073816671681. Epub 2016 Oct 15.

Reference Type RESULT
PMID: 27742862 (View on PubMed)

Jethwa A, Mink J, Macarthur C, Knights S, Fehlings T, Fehlings D. Development of the Hypertonia Assessment Tool (HAT): a discriminative tool for hypertonia in children. Dev Med Child Neurol. 2010 May;52(5):e83-7. doi: 10.1111/j.1469-8749.2009.03483.x.

Reference Type RESULT
PMID: 20540176 (View on PubMed)

Haberfehlner H, Goudriaan M, Bonouvrie LA, Jansma EP, Harlaar J, Vermeulen RJ, van der Krogt MM, Buizer AI. Instrumented assessment of motor function in dyskinetic cerebral palsy: a systematic review. J Neuroeng Rehabil. 2020 Mar 5;17(1):39. doi: 10.1186/s12984-020-00658-6.

Reference Type RESULT
PMID: 32138731 (View on PubMed)

Hadders-Algra M. Early Diagnostics and Early Intervention in Neurodevelopmental Disorders-Age-Dependent Challenges and Opportunities. J Clin Med. 2021 Feb 19;10(4):861. doi: 10.3390/jcm10040861.

Reference Type RESULT
PMID: 33669727 (View on PubMed)

Other Identifiers

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2024 - 1944

Identifier Type: -

Identifier Source: org_study_id

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