AIM To determine the features cited by motor phenotyping experts when identifying dystonia in people with cerebral palsy (CP). METHOD Dystonia identification in CP, particularly when comorbid with spasticity, can be difficult. The dystonia diagnostic criterion standard remains subjective visual identification by expert consensus. For this qualitative study, we conducted an inductive thematic analysis of consensus-building discussions between three pediatric movement disorder physicians as they identified the presence or absence of dystonia in gait videos of 40 participants with spastic CP and periventricular leukomalacia. RESULTS Unanimous consensus about the presence or absence of dystonia was achieved for 34 out of 40 videos. Two main themes were present during consensus-building discussions as videos were evaluated for dystonia: (1) unilateral leg or foot adduction that was variable over time, and (2) difficulty in identifying dystonia. Codes contributing to the first theme were more likely to be cited by a discussant when they felt dystonia was present (as opposed to absent) in a video (χ2 test, p=0.004). DISCUSSION These results describe the gait features cited by experts during consensus-building discussion as they identify dystonia in ambulatory people with CP. Qualitative thematic analysis of these discussions could help codify the subjective process of dystonia diagnosis.

中文翻译：

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脑瘫患者肌张力障碍的步态特征

目的 确定运动表型专家在识别脑瘫 (CP) 患者肌张力障碍时引用的特征。方法 鉴别 CP 中的肌张力障碍，特别是当伴有痉挛时，可能很困难。肌张力障碍诊断标准仍然是专家共识的主观视觉识别。对于这项定性研究，我们对三位儿科运动障碍医生之间达成共识的讨论进行了归纳主题分析，因为他们确定了 40 名痉挛性 CP 和脑室周围白质软化参与者的步态视频中是否存在肌张力障碍。结果 40 个视频中的 34 个就是否存在肌张力障碍达成了一致意见。在对视频进行肌张力障碍评估时，在建立共识的讨论中出现了两个主要主题：(1) 单侧腿或足内收随时间变化，以及 (2) 难以识别肌张力障碍。当讨论者感到视频中存在（而不是不存在）肌张力障碍时，有助于第一个主题的代码更有可能被讨论者引用（χ2 检验，p=0.004）。讨论 这些结果描述了专家在建立共识的讨论中引用的步态特征，因为他们确定了 CP 患者的走动性肌张力障碍。对这些讨论的定性主题分析有助于编纂肌张力障碍诊断的主观过程。讨论 这些结果描述了专家在达成共识的讨论中引用的步态特征，因为他们确定了 CP 患者的行走障碍。对这些讨论的定性主题分析有助于编纂肌张力障碍诊断的主观过程。讨论 这些结果描述了专家在建立共识的讨论中引用的步态特征，因为他们确定了 CP 患者的走动性肌张力障碍。对这些讨论的定性主题分析有助于编纂肌张力障碍诊断的主观过程。