Paratonia: a Delphi procedure for consensus definition

Hans Hobbelen, Raymond T C M Koopmans, Frans R J Verhey, Roland P S Van Peppen, Rob A. de Bie

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

BACKGROUND AND PURPOSE: Paratonia is a motor problem that develops during the course of dementia. Definitions of paratonia used in the literature differ considerably, which has clinical implications and may lead to an undesirable heterogeneity in study populations. For this reason, we initiated a Delphi procedure with known experts in the field to establish an operational consensus definition of paratonia.

METHODS: The Delphi procedure involved an anonymous and multistage approach presented as a questionnaire, with each stage building on the results of the previous one in order to reach consensus on the definition of paratonia.

RESULTS: Eight of 17 experts agreed to participate in the study. After 4 rounds, the participants reached consensus on the following definition: paratonia is a form of hypertonia with an involuntary variable resistance during passive movement. The nature of paratonia may change with progression of dementia (eg, from active assistance (aka Mitgehen) to active resistance). The degree of resistance depends on the speed of movement (eg, slow > low resistance, fast > high resistance). The degree of paratonia is proportional to the amount of force applied and increases with progression of dementia. The resistance to passive movement is in any direction and there is no clasp-knife phenomenon.

CONCLUSION: The Delphi procedure resulted in a comprehensive, operational definition of paratonia. Future research should focus on the reliability and validity of this definition.

Original languageEnglish
Pages (from-to)50-56
JournalJournal of geriatric physical therapy
Volume29
Issue number2
Publication statusPublished - 2006

Keywords

  • delphi technique
  • dementia
  • paratonia
  • movement disorders
  • muscle hypertonia

Cite this

Hobbelen, H., Koopmans, R. T. C. M., Verhey, F. R. J., Van Peppen, R. P. S., & de Bie, R. A. (2006). Paratonia: a Delphi procedure for consensus definition. Journal of geriatric physical therapy, 29(2), 50-56.
Hobbelen, Hans ; Koopmans, Raymond T C M ; Verhey, Frans R J ; Van Peppen, Roland P S ; de Bie, Rob A. / Paratonia : a Delphi procedure for consensus definition. In: Journal of geriatric physical therapy. 2006 ; Vol. 29, No. 2. pp. 50-56.
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Hobbelen, H, Koopmans, RTCM, Verhey, FRJ, Van Peppen, RPS & de Bie, RA 2006, 'Paratonia: a Delphi procedure for consensus definition' Journal of geriatric physical therapy, vol. 29, no. 2, pp. 50-56.

Paratonia : a Delphi procedure for consensus definition. / Hobbelen, Hans; Koopmans, Raymond T C M; Verhey, Frans R J; Van Peppen, Roland P S; de Bie, Rob A.

In: Journal of geriatric physical therapy, Vol. 29, No. 2, 2006, p. 50-56.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Paratonia

T2 - a Delphi procedure for consensus definition

AU - Hobbelen, Hans

AU - Koopmans, Raymond T C M

AU - Verhey, Frans R J

AU - Van Peppen, Roland P S

AU - de Bie, Rob A.

PY - 2006

Y1 - 2006

N2 - BACKGROUND AND PURPOSE: Paratonia is a motor problem that develops during the course of dementia. Definitions of paratonia used in the literature differ considerably, which has clinical implications and may lead to an undesirable heterogeneity in study populations. For this reason, we initiated a Delphi procedure with known experts in the field to establish an operational consensus definition of paratonia.METHODS: The Delphi procedure involved an anonymous and multistage approach presented as a questionnaire, with each stage building on the results of the previous one in order to reach consensus on the definition of paratonia.RESULTS: Eight of 17 experts agreed to participate in the study. After 4 rounds, the participants reached consensus on the following definition: paratonia is a form of hypertonia with an involuntary variable resistance during passive movement. The nature of paratonia may change with progression of dementia (eg, from active assistance (aka Mitgehen) to active resistance). The degree of resistance depends on the speed of movement (eg, slow > low resistance, fast > high resistance). The degree of paratonia is proportional to the amount of force applied and increases with progression of dementia. The resistance to passive movement is in any direction and there is no clasp-knife phenomenon.CONCLUSION: The Delphi procedure resulted in a comprehensive, operational definition of paratonia. Future research should focus on the reliability and validity of this definition.

AB - BACKGROUND AND PURPOSE: Paratonia is a motor problem that develops during the course of dementia. Definitions of paratonia used in the literature differ considerably, which has clinical implications and may lead to an undesirable heterogeneity in study populations. For this reason, we initiated a Delphi procedure with known experts in the field to establish an operational consensus definition of paratonia.METHODS: The Delphi procedure involved an anonymous and multistage approach presented as a questionnaire, with each stage building on the results of the previous one in order to reach consensus on the definition of paratonia.RESULTS: Eight of 17 experts agreed to participate in the study. After 4 rounds, the participants reached consensus on the following definition: paratonia is a form of hypertonia with an involuntary variable resistance during passive movement. The nature of paratonia may change with progression of dementia (eg, from active assistance (aka Mitgehen) to active resistance). The degree of resistance depends on the speed of movement (eg, slow > low resistance, fast > high resistance). The degree of paratonia is proportional to the amount of force applied and increases with progression of dementia. The resistance to passive movement is in any direction and there is no clasp-knife phenomenon.CONCLUSION: The Delphi procedure resulted in a comprehensive, operational definition of paratonia. Future research should focus on the reliability and validity of this definition.

KW - delphi technique

KW - dementia

KW - paratonia

KW - movement disorders

KW - muscle hypertonia

KW - paratonie

M3 - Article

VL - 29

SP - 50

EP - 56

JO - Journal of geriatric physical therapy

JF - Journal of geriatric physical therapy

SN - 2152-0895

IS - 2

ER -

Hobbelen H, Koopmans RTCM, Verhey FRJ, Van Peppen RPS, de Bie RA. Paratonia: a Delphi procedure for consensus definition. Journal of geriatric physical therapy. 2006;29(2):50-56.