Quantification of upper extremity function and range of motion in children with cerebral palsy

Area of Science:

• Pediatric Rehabilitation
• Neurology
• Orthopedics

Background:

• Cerebral palsy (CP) significantly impacts upper extremity function and range of motion in children.
• Standardized and reliable assessment tools are crucial for effective clinical management of CP.
• Previous evaluations may lack consistency in busy clinical environments.

Purpose of the Study:

• To evaluate the hypothesis that upper extremity function and range of motion in children with CP can be reliably quantified in a clinical setting.
• To determine the inter- and intrarater reliability of the modified House Functional Classification (MHC) system.
• To assess the reliability of the Upper Extremity Rating Scale (UERS) for documenting upper extremity range of motion.

Main Methods:

• Sixty-five children with CP and upper extremity spasticity were evaluated.
• Occupational therapists and orthopedic surgeons independently assessed participants using the MHC and UERS.
• Inter- and intrarater reliability were calculated using intraclass correlation coefficients (ICCs) and weighted kappa values.

Main Results:

• The MHC demonstrated good to excellent interrater (ICC=0.94) and intrarater (ICC=0.96) agreement.
• The UERS showed good to excellent inter-rater (kappa 0.66-0.81) and intrarater (kappa 0.64-0.88) agreement.
• Both instruments proved reliable and reproducible in a clinical setting.

Conclusions:

• The modified House Functional Classification (MHC) system is a reliable tool for assessing upper extremity function in children with CP.
• The Upper Extremity Rating Scale (UERS) is a reliable instrument for documenting upper extremity range of motion in this population.
• These standardized instruments are efficient and can be effectively utilized by clinicians managing children with CP.