Grading of Adductor Spasticity in Cerebral Palsy – A New Approach

Spastic cerebral palsy is the most common form of cerebral palsy. Spasticity in hip adductor causes discomfort, stiffness and difficulties in performing physical activities such as seating, transfers and walking. Grading of hip adductor spasticity is still a challenge in the field of rehabilitation. A simple method to assess hip adductor spasticity and use it as outcome measures of intervention is needed in general clinical practice. We propose a visual method for grading hip adductor spasticity i.e grade 1= touch at ankle, grade 2 = crossing at ankle and grade 3 = crossing at knee in spastic cerebral palsy children. We followed 60 spastic cerebral palsy children over a period of three months on oral antispastic medication and found it very useful to assess response to drug. Intially hip adductor spasticity of grade 3 was observed in 10 %, grade 2- 8.33%, grade 1- 26.66% and 45% patients had no scissoring. After three months of drug therapy improvement was observed as grade 3 seen in 1 %, grade 2 - 7%, grade 1 - 23.33% and patients with no scissoring rose to 63.3%. These observations show that visual method for hip adductor spasticity is a simple and helpful method for grading response to therapeutic intervention.