Background and aims The clinical assessment of hypotonia remains contentious in the literature. The reality is that the assessment is often subjective in nature. Despite the underlying causative factors, the clinical presentation of hypotonia is however considered to be similar in most cases. Differentiating the likely causes of hypotonia is important in sparing some infants and children from invasive diagnostic tests and there also exist a number of causes of hypotonia for which there is no definitive laboratory or imaging tests, namely idiopathic hypotonia, so the role of the clinical and developmental assessments remain important. The author describes a process in moving clinicians towards consensus.
Design Research, using across stage mixed methods was used, within a pragmatic stance. Design research acknowledges the complex and dynamic relationship between theory and application and provides a relevant foundation to guide practice by methods that are both theoretically underpinned and empirically tested. The author combined evidenced-based methods that assisted in the design of a clinical algorithm for practice (Table 1). Three phases were implemented viz. preliminary phase, prototyping and assessment phase.
The visualisation of the research process is described in Figure 1 below.
Results and conclusions With use of design research, and following a systematic process, the authors were able to formulate a process in order to initiate movement towards consensus on the assessment of hypotonia. These processes followed a systematic and evidenced-based process and culminated in the development of a clinical algorithm.