Brief instruction found to help
A study of physical therapists and occupational therapists in Texas, USA, found almost 3/4 unfamiliar with HSP. 9/10 had never received instruction on HSP. Diagnostic accuracy improved significantly after training.
The relevance to the Australian context is unknown although anecdotally reports from people with HSP of allied health professionals unfamiliar with HSP are common.
Aims: The aim of this two-part, prospective study was to determine therapist familiarity with HSP and examine diagnostic accuracy between individuals with HSP and those with Spastic Diplegic Cerebral Palsy (SD-CP).
Methods: Part-one surveyed physical therapists (PT) and physical therapist assistants (PTA) throughout Texas to determine familiarity with HSP and its gait deviations. Part-two examined accuracy in differential diagnosis of HSP versus SD-CP using gait analysis and the effects of an educational module on upper body gait deviations observed in individuals with HSP.
Results: Both PTs and PTAs indicated a high degree (≥73.2%) of unfamiliarity with HSP. While a majority of respondents (≥88.7%) indicated use of observational gait analysis in clinical practice, ≥92.5% indicated never receiving instruction on HSP or its associated gait deviations. Whole group analysis revealed diagnostic accuracy increased 21.7% post educational module. In addition, individual case diagnostic accuracy yielded significant improvement in 14 out of 20 cases.
Conclusions: Physical and occupational therapists are in a unique position to assist with the identification and distinction of HSP from CP. This study demonstrated that brief instruction on common upper body gait deviations seen in individuals with HSP may improve a clinician’s ability to distinguish SD-CP from HSP via gait analysis.
SOURCE: Phys Occup Ther Pediatr. 2020 Sep 17;1-15. doi: 10.1080/01942638.2020.1819934. Online ahead of print. PMID: 32942942
Familiarity with Hereditary Spastic Paraplegia (HSP) and Differentiation of Upper Body Gait Characteristics between Children with HSP and Spastic Diplegic Cerebral Palsy
- School of Physical Therapy, Texas Woman’s University, Houston, Texas, USA.
- Shriners Hospitals for Children, Houston, Texas, USA.
- Elite Physical Therapy, Graham, Washington, USA.
- Neurological Residency Program, Harris Health System, Houston, Texas, US