Naidoo Pragashnie
School of Health Sciences, Discipline of Occupational Therapy, University of KwaZulu Natal, Westville, South Africa.
JMIR Res Protoc. 2014 Dec 5;3(4):e71. doi: 10.2196/resprot.3581.
Assessing muscle tone in children is essential during the neurological assessment and is often essential in ensuring a more accurate diagnosis for appropriate management. While there have been advances in child neurology, there remains much contention around the subjectivity of the clinical assessment of hypotonia, which is often the first step in the diagnostic process.
In response to this challenge, the objective of the study is to develop and validate a prototype of a decision making process in the form of a clinical algorithm that will guide clinicians during this assessment process.
Design research within a pragmatic stance will be employed in this study. Multi-phase stages of assessment, prototyping and evaluation will occur. These will include processes that include a systematic review, processes of reflection and action as well as validation methods. Given the mixed methods nature of this study, use of NVIVO or ATLAS-ti will be used in the analysis of qualitative data and SPSS for quantitative data.
Initial results from the systematic review revealed a paucity of scientific literature that documented the objective assessment of hypotonia in children. The review identified the need for more studies with greater methodological rigor in order to determine best practice with respect to the methods used in the assessment of low muscle tone in the paediatric population.
It is envisaged that this proposal will contribute to a more accurate clinical diagnosis of children with low muscle tone in the absence of a gold standard. We anticipate that the use of this tool will ultimately assist clinicians towards moving to evidenced based practice whilst upholding best practice in the care of children with hypotonia.
在神经学评估过程中，评估儿童的肌张力至关重要，而且对于确保做出更准确的诊断以进行适当治疗也常常必不可少。尽管儿童神经学已有进展，但围绕肌张力减退临床评估的主观性仍存在诸多争议，而这往往是诊断过程的第一步。
为应对这一挑战，本研究的目的是开发并验证一种临床算法形式的决策过程原型，该原型将在这一评估过程中为临床医生提供指导。
本研究将采用务实立场的设计研究。将进行多阶段的评估、原型设计和评估。这些将包括系统评价过程、反思与行动过程以及验证方法。鉴于本研究的混合方法性质，定性数据分析将使用NVIVO或ATLAS-ti，定量数据分析将使用SPSS。
系统评价的初步结果显示，记录儿童肌张力减退客观评估的科学文献匮乏。该评价确定需要开展更多方法更严谨的研究，以便确定儿科人群中低肌张力评估方法的最佳实践。
预计本提议将有助于在缺乏金标准的情况下更准确地临床诊断低肌张力儿童。我们预计，使用这一工具最终将帮助临床医生转向循证实践，同时在照顾低肌张力儿童方面坚持最佳实践。
