Reliability and responsiveness of the Barry–Albright Dystonia Scale

Abstract

The reliability and responsiveness of the Barry-Albright Dystonia (BAD) Scale, a 5-point ordinal severity scale for secondary dystonia, was assessed. For interrater reliability, 13 raters scored 10 videotaped patients; for intrarater reliability, two raters rated the videotape again. For test-retest reliability, patients were rated on two occasions. Four inexperienced raters scored patients, received training, then scored additional patients. To assess responsiveness, we compared patient and physician global ratings of change (better, same, and worse) with BAD Scale score changes for 18 patients on intrathecal baclofen (ITB) trials. We assessed reliability with the intraclass correlation coefficient (ICC). The mean ICC for total BAD Scale scores were as follows: interrater reliability 0.866, intrarater reliability 0.967 and 0.978, test-retest reliability 0.978 (before training) and 0.967 (after training). We found the BAD Scale responsive to change, with most improved scores in patients rated by the patient, family, and neurosurgeon as 'better'. The total scores were reliable for experienced raters. We recommend training for clinicians interested in using the scale.

Complementary dietary treatment using lysine-free, arginine-fortified amino acid supplements in glutaric aciduria type I — A decade of experience

“…Severity of dystonia was rated according to the Barry-Albright dystonia scale, a 5-point ordinal scale for 8 body regions (minimum: 0 point, maximum: 32 points) [49]. Furthermore, we determined the age at achievement of five gross motor milestones including head control, sitting without support, hands-and-knees crawling, standing alone and walking alone.…”

Cathodal Transcranial Direct Current Stimulation in Children With Dystonia

“…All participants were rated on the Barry-Albright Dystonia Scale at the beginning and end of the session. 19 Participants sat in a chair or their own wheelchair and placed both hands flat on the surface of a table with palms down in a comfortable position. The table was adjusted to a comfortable height for each participant.…”

Further Evaluation of the Scoring, Reliability, and Validity of the Hypertonia Assessment Tool (HAT)

“…For example, the reliability of the Barry-Albright Dystonia Scale was evaluated based on review of videotapes of patients with dystonia. 3 Dystonia is variable and therefore certain HAT dystonia items may be difficult to gauge on the initial examination. It was hypothesized that the clinician administering the HAT may benefit from reviewing a videotape of the assessment prior to scoring.…”