{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T08:42:47Z","timestamp":1790671367801,"version":"4.1.0"},"reference-count":20,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2020,8,11]],"date-time":"2020-08-11T00:00:00Z","timestamp":1597104000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"S\u00e4llskapet Barnav\u00e5rd, S\u00e4llsyntafonden, Norrbacka-Eugeniastiftelsen, S\u00d6S kliniska forskarskola, and Linnea &amp; Josef Carlssons Stiftelse","award":["-"],"award-info":[{"award-number":["-"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: The Dyskinesia Impairment Scale (DIS) is a new assessment scale for dystonia and choreoathetosis in children and youth with dyskinetic cerebral palsy. Today, the Burke\u2013Fahn\u2013Marsden Dystonia Rating Scale (BFM) is mostly used to assess dystonia in children with inherited dystonia. The aim of this study was to assess reliability and validity of the DIS in children and youth with inherited or idiopathic dystonia. Methods: Reliability was measured by (1) the intraclass correlation coefficients (ICCs) for inter-rater and test-retest reliability, as well as (2) standard error of measurement (SEM) and minimal detectable difference (MDD). For concurrent validity of the DIS-dystonia subscale, the BFM was administered. Results: In total, 11 males and 9 females (median age 16 years and 7 months, range 6 to 24 years) were included. For inter-rater reliability, the ICCs for the DIS total score and the dystonia and choreoathetosis subscale scores were 0.83, 0.87, and 0.71, respectively. For test-retest reliability, the ICCs for the DIS total score and the dystonia and choreoathetosis subscale scores were 0.95, 0.88, and 0.93, respectively. The SEM and MDD for the total DIS were 3.98% and 11.04%, respectively. The Spearman correlation coefficient between the dystonia subscale and the BFM was 0.88 (p &lt; 0.01). Conclusions: Good to excellent inter-rater, test-retest reliability, and validity were found for the total DIS and the dystonia subscale. The choreoathetosis subscale showed moderate inter-rater reliability and excellent test-retest reliability. The DIS may be a promising tool to assess dystonia and choreoathetosis in children and young adults with inherited or idiopathic dystonia.<\/jats:p>","DOI":"10.3390\/jcm9082597","type":"journal-article","created":{"date-parts":[[2020,8,11]],"date-time":"2020-08-11T10:56:12Z","timestamp":1597143372000},"page":"2597","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Reliability and Validity of the Dyskinesia Impairment Scale in Children and Young Adults with Inherited or Idiopathic Dystonia"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5626-7068","authenticated-orcid":false,"given":"Annika","family":"Danielsson","sequence":"first","affiliation":[{"name":"Department of Women\u2019s and Children\u00b4s Health, Karolinska Institutet, 17176 Stockholm, Sweden"},{"name":"Sach\u2019s Children and Youth Hospital, Stockholm South General Hospital, 11883 Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inti","family":"Vanmechelen","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Sciences, KU Leuven Campus Bruges, 8200 Bruges, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cecilia","family":"Lidbeck","sequence":"additional","affiliation":[{"name":"Department of Women\u2019s and Children\u00b4s Health, Karolinska Institutet, 17176 Stockholm, Sweden"},{"name":"Neuropediatric Department, Karolinska University Hospital, 17176 Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lena","family":"Krumlinde-Sundholm","sequence":"additional","affiliation":[{"name":"Department of Women\u2019s and Children\u00b4s Health, Karolinska Institutet, 17176 Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Els","family":"Ortibus","sequence":"additional","affiliation":[{"name":"Department of Development and Regeneration, KU Leuven, 3000 Leuven, Belgium"},{"name":"Cerebral Palsy Clinic, University Hospitals Leuven-Campus Pellenberg, 3000 Leuven, Belgium"},{"name":"Centre for Developmental Disabilities, 3000 Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elegast","family":"Monbaliu","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Sciences, KU Leuven Campus Bruges, 8200 Bruges, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0456-8029","authenticated-orcid":false,"given":"Kristina","family":"Tedroff","sequence":"additional","affiliation":[{"name":"Department of Women\u2019s and Children\u00b4s Health, Karolinska Institutet, 17176 Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,8,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1002\/mds.25475","article-title":"Phenomenology and classification of dystonia: A consensus update","volume":"28","author":"Albanese","year":"2013","journal-title":"Mov. Disord."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1016\/j.parkreldis.2018.08.008","article-title":"Motor and non-motor determinants of health-related quality of life in young dystonia patients","volume":"58","author":"Eggink","year":"2019","journal-title":"Parkinsonism Relat. Disord."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1538","DOI":"10.1002\/mds.23088","article-title":"Definition and classification of hyperkinetic movements in childhood","volume":"25","author":"Sanger","year":"2010","journal-title":"Mov. Disord."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1292","DOI":"10.1111\/j.1468-1331.2011.03649.x","article-title":"Treatment for dystonia in childhood","volume":"19","author":"Roubertie","year":"2012","journal-title":"Eur. J. Neurol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1111\/j.1469-8749.2011.04209.x","article-title":"The Dyskinesia Impairment Scale: A new instrument to measure dystonia and choreoathetosis in dyskinetic cerebral palsy","volume":"54","author":"Monbaliu","year":"2012","journal-title":"Dev. Med. Child Neurol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1212\/WNL.35.1.73","article-title":"Validity and reliability of a rating scale for the primary torsion dystonias","volume":"35","author":"Burke","year":"1985","journal-title":"Neurology"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1111\/j.1469-8749.1999.tb00626.x","article-title":"Reliability and responsiveness of the Barry-Albright Dystonia Scale","volume":"41","author":"Barry","year":"1999","journal-title":"Dev. Med. Child Neurol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1016\/j.pediatrneurol.2008.07.002","article-title":"Movement disorder-childhood rating scale: Reliability and validity","volume":"39","author":"Battini","year":"2008","journal-title":"Pediatr. Neurol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1002\/mds.10377","article-title":"Rating scales for dystonia: A multicenter assessment","volume":"18","author":"Comella","year":"2003","journal-title":"Mov. Disord."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"786","DOI":"10.1111\/dmcn.13452","article-title":"A systematic review of scales to measure dystonia and choreoathetosis in children with dyskinetic cerebral palsy","volume":"59","author":"Stewart","year":"2017","journal-title":"Dev. Med. Child Neurol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"874","DOI":"10.1002\/mds.25579","article-title":"Dystonia rating scales: Critique and recommendations","volume":"28","author":"Albanese","year":"2013","journal-title":"Mov. Disord."},{"key":"ref_12","unstructured":"Portney, L.G., and Watkins, M.P. (2009). Foundations of Clinical Research: Applications to Practice, Pearson\/Prentice Hall."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"570","DOI":"10.1111\/j.1469-8749.2009.03581.x","article-title":"Rating scales for dystonia in cerebral palsy: Reliability and validity","volume":"52","author":"Monbaliu","year":"2010","journal-title":"Dev. Med. Child Neurol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1016\/j.ejpn.2012.10.004","article-title":"Can the Dyskinesia Impairment Scale be used by inexperienced raters? A reliability study","volume":"17","author":"Monbaliu","year":"2013","journal-title":"Eur. J. Paediatr. Neurol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1111\/dmcn.14424","article-title":"Test-retest reliability of the Dyskinesia Impairment Scale: Measuring dystonia and choreoathetosis in dyskinetic cerebral palsy","volume":"62","author":"Vanmechelen","year":"2020","journal-title":"Dev. Med. Child Neurol."},{"key":"ref_16","first-page":"1","article-title":"A simplified guide to determination of sample size requirements for estimating the value of intraclass correlation coefficient: A review","volume":"12","author":"Bujang","year":"2017","journal-title":"Arch. Orofac. Sci."},{"key":"ref_17","unstructured":"American Academy of Orthopaedic Surgeons (1988). Joint Motion: Method of Measuring and Recording, Churchill Livingstone."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1111\/j.1469-8749.1997.tb07414.x","article-title":"Development and reliability of a system to classify gross motor function in children with cerebral palsy","volume":"39","author":"Palisano","year":"1997","journal-title":"Dev. Med. Child Neurol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"744","DOI":"10.1111\/j.1469-8749.2008.03089.x","article-title":"Content validity of the expanded and revised Gross Motor Function Classification System","volume":"50","author":"Palisano","year":"2008","journal-title":"Dev. Med. Child Neurol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1017\/S0012162206001162","article-title":"The Manual Ability Classification System (MACS) for children with cerebral palsy: Scale development and evidence of validity and reliability","volume":"48","author":"Eliasson","year":"2006","journal-title":"Dev. Med. Child Neurol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/9\/8\/2597\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T09:59:01Z","timestamp":1760176741000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/9\/8\/2597"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,8,11]]},"references-count":20,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2020,8]]}},"alternative-id":["jcm9082597"],"URL":"https:\/\/doi.org\/10.3390\/jcm9082597","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,8,11]]}}}