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Characteristics of Hypotonia in Children: A Consensus Opinion of Pediatric Occupational and Physical Therapists

Martin, Kathy PT, DHS; Inman, Jill PT; Kirschner, Abby PT; Deming, Katie PT; Gumbel, Rachel PT; Voelker, Lindsey PT

doi: 10.1097/01.pep.0000186506.48500.7c
Research Report

Purpose: The term hypotonia is often used to describe children with reduced muscle tone, yet it remains abstract and undefined. The purpose of this study was to identify characteristics of children with hypotonia to begin the process of developing an operational definition of hypotonia.

Methods: Three hundred physical and occupational therapists were systematically selected from the memberships of the Pediatric Section of the American Physical Therapy Association and the Developmental Delay Section of the American Occupational Therapy Association and asked to complete an open-ended survey exploring characteristics of strength, endurance, mobility, posture, and flexibility.

Results: The response rate was 26.6%. Forty-six physical therapists and 34 occupational therapists participated. The criterion for consensus about a characteristic was being mentioned by at least 25% of respondents from each discipline. The consensus was that children with hypotonia have decreased strength, decreased activity tolerance, delayed motor skills development, rounded shoulder posture, with leaning onto supports, hypermobile joints, increased flexibility, and poor attention and motivation.

Conclusion: An objective tool for defining and quantifying hypotonia does not exist. A preliminary characterization of children with hypotonia was established, but further research is needed to achieve objectivity and clarity.

This survey found that some characteristics of hypotonia reported by OTs and PTs have not been previously reported to be associated with hypotonia. The authors suggest further research to clarify the characteristics of this disorder.

Krannert School of Physical Therapy University of Indianapolis, Indianapolis, IN

Address correspondence to: Kathy Martin, PT, DHS, 1400 E. Hanna Ave., Indianapolis, IN 46227. Email:

Grant support: This study was supported by a grant from the Krannert School of Physical Therapy at the University of Indianapolis.

© 2005 Lippincott Williams & Wilkins, Inc.