INTRODUCTION Power wheelchairs (PW) with head/foot steering systems are used as an alternative to joysticks in children with severe dyskinetic cerebral palsy (DCP). Mobility training programs are unstandardized to date, and insight on dystonia, choreoathetosis, and mobility performance may lead to greater independent mobility. OBJECTIVE To map the presence and severity of dystonia and choreoathetosis during PW mobility in DCP and their relation with mobility performance. METHODS Ten participants with DCP performed four PW mobility tasks using a head/foot steering system. Dystonia and choreoathetosis in the neck and arm regions were evaluated using the Dyskinesia Impairment Mobility Scale (DIMS). PW mobility performance was assessed using time-on-task and the number of errors during performance. The Wilcoxon-signed rank test and the Spearman's correlation coefficients were used to explore differences and correlations. RESULTS Median levels of dystonia (83.6%) were significantly higher (p < 0.01) than median levels of choreoathetosis (34.4%). Positive significant correlations were found between the Arm Proximal DIMS and the PW mobility experience (rs=-0.92, p < 0.001), and between the Arm Distal DIMS and the number of errors (rs = 0.66, p = 0.039) during mobility performance. CONCLUSIONS Dystonia is more present and severe during PW mobility than choreoathetosis. The hypertonic hallmark of dystonia may mask the hyperkinetic hallmark of choreoathetosis, resulting in lower median levels. Results may suggest that with an increase in driving experience, children with DCP adopt deliberate strategies to minimize the negative impact of arm overflow movements on mobility performance, however, future research with bigger sample size and additional outcome measures is strongly encouraged.

中文翻译：

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运动障碍性脑瘫儿童和青少年的肌张力障碍和舞蹈手足徐动症的存在和严重程度与电动轮椅行动能力的关系

引言 带有头/脚转向系统的电动轮椅 (PW) 被用作严重运动障碍性脑瘫 (DCP) 儿童的操纵杆的替代品。迄今为止，行动能力训练计划尚未标准化，对肌张力障碍、舞蹈手足徐动症和行动能力表现的深入了解可能会导致更大的独立行动能力。目的 绘制 DCP 中 PW 活动期间肌张力障碍和舞蹈手足徐动症的存在和严重程度及其与活动能力的关系。方法 十名 DCP 参与者使用头/脚转向系统执行四项 PW 移动任务。使用运动障碍障碍活动量表 (DIMS) 评估颈部和手臂区域的肌张力障碍和舞蹈手足徐动症。使用任务时间和执行期间的错误数量来评估 PW 移动性能。Wilcoxon 签名秩检验和 Spearman' s 相关系数用于探索差异和相关性。结果 肌张力障碍的中位水平 (83.6%) 显着高于 (p < 0.01) 舞蹈手足徐动的中位水平 (34.4%)。发现手臂近端 DIMS 与 PW 移动体验（rs=-0.92，p < 0.001）之间以及手臂远端 DIMS 与移动性能期间的错误数量（rs = 0.66，p = 0.039）之间存在显着正相关。结论 与舞蹈手足徐动症相比，PW 活动期间肌张力障碍更为严重。肌张力障碍的高渗标志可能掩盖了舞蹈手足徐动的高渗标志，导致中位水平较低。结果可能表明，随着驾驶经验的增加，患有 DCP 的儿童采取深思熟虑的策略，以尽量减少手臂溢出运动对活动能力的负面影响，