Construct validity and reliability of the Selective Control Assessment of the Lower Extremity in children with cerebral palsy
van der Linden, Marietta
van Hedel, H.
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Balzer, J., Marsico, P., Mitteregger, E., van der Linden, M., Mercer, T. & van Hedel, H. (2016) Construct validity and reliability of the Selective Control Assessment of the Lower Extremity in children with cerebral palsy. Developmental Medicine & Child Neurology, 58(2), pp. 167-172.
AIM: Assessing impaired selective voluntary movement control in children with cerebral palsy (CP) has gained increasing interest. We investigated construct validity and intra- and interrater reliability of the Selective Control Assessment of the Lower Extremity (SCALE). METHOD: Thirty-nine children (21 males, 18 females) with spastic CP, mean age 12 years 6 months [range 6y 11mo-19y 9mo], Gross Motor Function Classification System (GMFCS) levels I to IV, participated. Differences in SCALE scores were determined on joint levels and between patients categorized according to their limb distribution and GMFCS levels. SCALE scores were correlated with the Fugl-Meyer Assessment, Manual Muscle Test, and Modified Ashworth Scale. To determine reliability, the SCALE was applied once and recorded on video. RESULTS: SCALE scores differed significantly between the less and more affected leg (p<0.001) and between most leg joints. Total SCALE scores differed significantly between GMFCS levels I and II. Correlations with Fugl-Meyer Assessment, Manual Muscle Test, and Modified Ashworth Scale were 0.88, 0.88, and -0.55 respectively. Intraclass correlation coefficients were all above 0.9, with the minimal detectable change below 2 points. INTERPRETATION: The SCALE appears to be a valid and reliable tool to assess selective voluntary movement control of the legs in children with spastic CP.