It's tricky: Rating alleviating maneuvers in cervical dystonia

dc.contributor.authorCisneros, Elizabeth
dc.contributor.authorStebbins, Glenn T.
dc.contributor.authorChen, Qiyu
dc.contributor.authorVu, Jeanne P.
dc.contributor.authorBenadof, Casey N.
dc.contributor.authorZhang, Zheng
dc.contributor.authorBarbano, Richard L.
dc.contributor.authorFox, Susan H.
dc.contributor.authorGoetz, Christopher G.
dc.contributor.authorJankovic, Joseph
dc.contributor.authorJinnah, Hyder A.
dc.contributor.authorPerlmutter, Joel S.
dc.contributor.authorAdler, Charles H.
dc.contributor.authorFactor, Stewart A.
dc.contributor.authorReich, Stephen G.
dc.contributor.authorRodriguez, Ramon
dc.contributor.authorSevert, Lawrence L.
dc.contributor.authorStover, Natividad P.
dc.contributor.authorBerman, Brian D.
dc.contributor.authorComella, Cynthia L.
dc.contributor.authorPeterson, David A.
dc.contributor.otherUniversity of California San Diego
dc.contributor.otherRush University
dc.contributor.otherUniversity of Rochester
dc.contributor.otherUniversity of Toronto
dc.contributor.otherUniversity Health Network Toronto
dc.contributor.otherBaylor College of Medicine
dc.contributor.otherEmory University
dc.contributor.otherWashington University (WUSTL)
dc.contributor.otherMayo Clinic
dc.contributor.otherUniversity of Maryland Baltimore
dc.contributor.otherHarvard University
dc.contributor.otherBeth Israel Deaconess Medical Center
dc.contributor.otherUniversity of Alabama Tuscaloosa
dc.contributor.otherVirginia Commonwealth University
dc.contributor.otherSalk Institute
dc.date.accessioned2023-09-28T22:03:50Z
dc.date.available2023-09-28T22:03:50Z
dc.date.issued2020
dc.description.abstractObjectives: To investigate hypothesized sources of error when quantifying the effect of the sensory trick in cervical dystonia (CD) with the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS-2), test strategies to mitigate them, and provide guidance for future research on the sensory trick. Methods: Previous analyses suggested the sensory trick (or "alleviating maneuver", AM) item be removed from the TWSTRS-2 because of its poor clinimetric properties. We hypothesized three sources of clinimetric weakness for rating the AM: 1) whether patients were given sufficient time to demonstrate their AM; 2) whether patients' CD was sufficiently severe for detecting AM efficacy; and 3) whether raters were inadvertently rating the item in reverse of scale instructions. We tested these hypotheses with video recordings and TWSTRS-2 ratings by one "site rater" and a panel of five "video raters" for each of 185 Dystonia Coalition patients with isolated CD. Results: Of 185 patients, 23 (12%) were not permitted sufficient testing time to exhibit an AM, 23 (12%) had baseline CD too mild to allow confident rating of AM effect, and 1 site- and 1 video-rater each rated the AM item with a reverse scoring convention. When these confounds were eliminated in step-wise fashion, the item's clinimetric properties improved. Conclusions: The AM's efficacy can contribute to measuring CD motor severity by addressing identified sources of error during its assessment and rating. Given the AM's sensitive diagnostic and potential pathophysiologic significance, we also provide guidance on modifications to how AMs can be assessed in future CD research.en_US
dc.format.mediumelectronic
dc.format.mimetypeapplication/pdf
dc.identifier.citationCisneros, E., Stebbins, G. T., Chen, Q., Vu, J. P., Benadof, C. N., Zhang, Z., Barbano, R. L., Fox, S. H., Goetz, C. G., Jankovic, J., Jinnah, H. A., Perlmutter, J. S., Adler, C. H., Factor, S. A., Reich, S. G., Rodriguez, R., Severt, L. L., Stover, N. P., Berman, B. D., … Peterson, D. A. (2020). It’s tricky: Rating alleviating maneuvers in cervical dystonia. In Journal of the Neurological Sciences (Vol. 419, p. 117205). Elsevier BV. https://doi.org/10.1016/j.jns.2020.117205
dc.identifier.doi10.1016/j.jns.2020.117205
dc.identifier.orcidhttps://orcid.org/0000-0002-0602-9942
dc.identifier.orcidhttps://orcid.org/0000-0002-4589-1332
dc.identifier.orcidhttps://orcid.org/0000-0001-9684-1813
dc.identifier.orcidhttps://orcid.org/0000-0003-2665-2763
dc.identifier.urihttps://ir.ua.edu/handle/123456789/12221
dc.languageEnglish
dc.language.isoen_US
dc.publisherElsevier
dc.subjectSensory trick
dc.subjectSensorimotor integration
dc.subjectCervical dystonia
dc.subjectSpasmodic torticollis
dc.subjectClinimetrics
dc.subjectSENSORY TRICKS
dc.subjectDOUBLE-BLIND
dc.subjectEFFICACY
dc.subjectSAFETY
dc.subjectClinical Neurology
dc.subjectNeurosciences
dc.titleIt's tricky: Rating alleviating maneuvers in cervical dystoniaen_US
dc.typeArticle
dc.typetext
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