Clinical utility of a patient-reported outcome for assessing spasticity in a pediatric population.
Elaine Hong Hatch, Ashlee M Jaffe, Laura A Prosser
PMID 40153272WHAT IT FOUND
The Zorowitz scale does not match physical measures like muscle tone or GMFCS levels, meaning it tracks a separate aspect of spasticity impact.
Caregiver-reported scores improved significantly after injections, suggesting the tool detects functional changes that standard clinical exams miss.
Key findings
01Baseline Zorowitz scores showed no relationship with GMFCS levels or Modified Ashworth Scale scores.
02Zorowitz scores changed significantly after injection therapy, with a median decrease of 3.0 points.
03Higher baseline Zorowitz scores were associated with greater decreases in score after injection.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study relied on caregiver proxy reports rather than patient self-report, which may diverge from patient experience as children age. Upper extremity muscle tone data were excluded due to insufficient records, limiting generalizability to arm/hand spasticity. The correlation between baseline and change scores was weak-moderate, making individual patient predictions difficult. Retrospective design means confounding factors like concurrent therapies or socioeconomic status could not be controlled. The Zorowitz scale has not been formally validated in pediatric populations; this study explores its utility but does not confirm psychometric properties.
Declared interests
The authors declared no financial support and no potential conflicts of interest.
The easy way to misread this
Do not assume that a low Zorowitz score means a child has low spasticity or good gross motor function. The scale measures perceived impact on daily life, which was not correlated with MAS or GMFCS scores in this study. A child can have high tone and poor gross motor function but a low Zorowitz score if their caregivers perceive the impact on daily activities as minimal.