{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:27:27Z","timestamp":1753878447372,"version":"3.41.2"},"reference-count":17,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,9,1]],"date-time":"2023-09-01T00:00:00Z","timestamp":1693526400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Child"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Currently, there are no standardized approaches to care or evaluation for tone dysfunction in Canada. The study authors hypothesize that there is significant practice variation across the country. This environmental scan is aimed to describe the current practice for management of paediatric patients with hypertonia across Canada.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A web\u2010based survey was developed by the authors with a multi\u2010disciplinary approach and sent to representative paediatric rehabilitation sites in each province in Canada. Disciplines at the rehabilitation sites surveyed included all or some of the following disciplines: physiatry, neurology, neurosurgery, plastic surgery, orthopaedic surgery, physiotherapy and occupational therapy. All statistical analyses were performed using the R statistical software version 4.0. Fifteen rehabilitation sites were contacted, and 12 sites were used for the final analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Cerebral palsy was found to be the most common diagnosis for tone dysfunction, with 58% of sites diagnosing greater than 20 new patients per year. In 67% of sites, patients were seen within a formal multidisciplinary clinic to manage hypertonia. All 12 sites utilized oral baclofen and gabapentin, and 92% of sites utilized trihexyphenidyl. Botulinum toxin injections were offered at 50% of sites. Upper and lower extremity surgical procedures were offered in 83% of the sites.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The information gained from this study provides some insight into the current practice across Canada for children with hypertonia. This study may assist in the development of a national, standardized strategy to tone management, potentially facilitating more equitable access to care for patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cch.13169","type":"journal-article","created":{"date-parts":[[2023,9,2]],"date-time":"2023-09-02T06:15:14Z","timestamp":1693635314000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Tone management: An environmental scan of current management practices across Canada"],"prefix":"10.1111","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1797-7825","authenticated-orcid":false,"given":"My\u2010An","family":"Tran","sequence":"first","affiliation":[{"name":"Children's Hospital of Eastern Ontario (CHEO)  Ottawa Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Madhura","family":"Thipse","sequence":"additional","affiliation":[{"name":"Children's Hospital of Eastern Ontario (CHEO)  Ottawa Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne","family":"Tsampalieros","sequence":"additional","affiliation":[{"name":"Children's Hospital of Eastern Ontario (CHEO)  Ottawa Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Webster","sequence":"additional","affiliation":[{"name":"Children's Hospital of Eastern Ontario (CHEO)  Ottawa Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"McCormick","sequence":"additional","affiliation":[{"name":"Children's Hospital of Eastern Ontario (CHEO)  Ottawa Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hana","family":"Alazem","sequence":"additional","affiliation":[{"name":"Children's Hospital of Eastern Ontario (CHEO)  Ottawa Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sunita","family":"Venkateswaran","sequence":"additional","affiliation":[{"name":"Children's Hospital of Eastern Ontario (CHEO)  Ottawa Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin","family":"Cheung","sequence":"additional","affiliation":[{"name":"Children's Hospital of Eastern Ontario (CHEO)  Ottawa Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin","family":"Smit","sequence":"additional","affiliation":[{"name":"Children's Hospital of Eastern Ontario (CHEO)  Ottawa Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Albert","family":"Tu","sequence":"additional","affiliation":[{"name":"Children's Hospital of Eastern Ontario (CHEO)  Ottawa Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,9]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/dmcn.15324"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/pch\/pxz061"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/dmcn.14252"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2019.09.035"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.acap.2018.05.004"},{"key":"e_1_2_10_7_1","unstructured":"Canadian Agency for Drugs and Technology in Health (CADTH). (2015).Environmental Scan Process. May: 15."},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPH.0000000000001942"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/jep.13234"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2019.103208"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/jpc.13754"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2020-321487"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2018-316309"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2017.1689"},{"key":"e_1_2_10_15_1","doi-asserted-by":"crossref","unstructured":"R Core Team. (2018).A language and environment for statistical computing [Internet]. R Foundation for Statistical Computing. Available from:https:\/\/www.gbif.org\/tool\/81287\/r-a-language-and-environment-for-statistical-computing.https:\/\/doi.org\/10.1109\/MCSE.2018.05329812","DOI":"10.1109\/MCSE.2018.05329812"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.2007.00001.x"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.2007.tb12610.x"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1503\/cjs.014219"}],"container-title":["Child: Care, Health and Development"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/cch.13169","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,12]],"date-time":"2025-04-12T09:40:16Z","timestamp":1744450816000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/cch.13169"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9]]},"references-count":17,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2024,1]]}},"alternative-id":["10.1111\/cch.13169"],"URL":"https:\/\/doi.org\/10.1111\/cch.13169","archive":["Portico"],"relation":{},"ISSN":["0305-1862","1365-2214"],"issn-type":[{"type":"print","value":"0305-1862"},{"type":"electronic","value":"1365-2214"}],"subject":[],"published":{"date-parts":[[2023,9]]},"assertion":[{"value":"2023-04-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-08-16","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-09-01","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e13169"}}