title: Pediatric tone management.
abstract: Tone management is one of the primary roles of a pediatric physiatrist. Hypertonicity frequently inhibits normal movement patterns in children with central nervous system lesions but at times can reinforce muscle group firing and be useful for a child's function. Treatment approaches should be individualized based on functional goals, degree of impairment, interference with care, and type and location of hypertonicity. Treatment plans should be created in collaboration with all individuals caring for the child. There are many causes of hypertonicity as well as many nonsurgical and surgical treatments. Historical and current evidence-based treatments are reviewed.
authors.affiliation: Division of Pediatric Rehabilitation Medicine, Department of Pediatrics, Rady Children's Hospital San Diego, University of California San Diego, 3020 Children's Way MC5096, San Diego, CA 92123, USA.
authors.forename: Sathya
authors.initials: S
authors.lastname: Vadivelu
authors.affiliation: Department of Physical Medicine and Rehabilitation, University of Colorado, Denver, CO, USA.
authors.forename: Anne
authors.initials: A
authors.lastname: Stratton
authors.affiliation: Department of Physical Medicine and Rehabilitation, University of Colorado, 4125 Briargate Parkway, Box 520, Colorado Springs, CO 80920, USA. Electronic address: wendy.pierce@childrenscolorado.org.
authors.forename: Wendy
authors.initials: W
authors.lastname: Pierce
mesh_terms: D002648:Child; D006801:Humans; D009122:Muscle Hypertonia / Q000150:complications / Q000188:drug therapy / Q000628:therapy*; D009128:Muscle Spasticity / Q000188:drug therapy / Q000209:etiology; D009407:Nerve Block; D019635:Neurosurgical Procedures; D019637:Orthopedic Procedures; D026741:Physical Therapy Modalities
keywords: Baclofen; Cerebral palsy; Dystonia; Hypertonia; Neurotomy; Pediatric; Rhizotomy; Spasticity