Construct validity and reliability of the Selective Control Assessment of the Lower Extremity in children with cerebral palsy. (20th May 2015)

• Record Type: Journal Article
• Authors: Balzer, Julia; Marsico, Petra; Mitteregger, Elena; van der Linden, Marietta L; Mercer, Thomas H; van Hedel, Hubertus J A
• Is Part Of: Developmental medicine & child neurology. Volume 58:Number 2(2016:Feb.)
• Page Start: 167
• Page End: 172
• Publication Date: 2015-05-20
• Subjects: Child development -- Periodicals; Pediatric neurology -- Periodicals; 616.8
• DOI: 10.1111/dmcn.12805
• Languages: English
• ISSNs: 0012-1622

Abstract

Abstract : 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. What this paper adds: The Selective Control Assessment of the Lower Extremity (SCALE) German version is a valid and reliable assessment for children with spastic CP. Total SCALE scores differed significantly between Gross Motor Function Classification System levels I versus II. Minimal detectable change of the SCALE is 2 points. This article is commented on by Fowler on page116 of this issue.