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A pilot study of observational motor assessment in infants and toddlers with spinal cord injury
Christina L Calhoun1, John P Gaughan, Ross S Chafetz
1Shriners Hospitals for Children, Philadelphia, Pennsylvania 19140, USA. ccalhoun@shrinenet.org
Insights
This study found that observational movement assessments show high reliability for muscles with spinal cord injury (SCI) that are fully functional or fully paralyzed. However, reliability is lower for partially impaired muscles in young children with SCI.
Area of Science:
- Pediatric neurology
- Rehabilitation medicine
- Movement science
Background:
- Assessing motor function in infants and children with spinal cord injury (SCI) is crucial for guiding treatment and rehabilitation.
- The International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) provides a framework for neurological assessment.
- The Active Movement Scale (AMS) is a component of the ISNCSCI used to evaluate muscle function through observational movement.
Purpose of the Study:
- To evaluate the interrater reliability of observational movement assessments in young children with SCI.
- To determine the consistency of joint action scoring using the AMS within the ISNCSCI framework.
- To assess the applicability of current observational movement assessment techniques in pediatric SCI populations.
Main Methods:
- A pilot study involving 5 consecutive pediatric patients diagnosed with SCI, aged 12 months to 4 years.
- Two independent examiners conducted observational movement assessments using the AMS testing technique and scoring criteria.
- Interrater agreement was calculated for joint actions assessed according to ISNCSCI guidelines.
Main Results:
- High agreement was observed between examiners for muscles that were unimpaired or completely paralyzed.
- Lower agreement was found for muscles exhibiting partial impairment or incomplete paralysis.
- This suggests variability in assessing subtle degrees of motor function in pediatric SCI.
Conclusions:
- Observational movement assessment, particularly using the AMS, shows promise as a reliable tool for certain muscle function evaluations in infants and toddlers with SCI.
- Further research and refinement of assessment criteria are necessary to improve reliability for partially impaired muscles in this population.
- Additional studies are needed to validate and enhance observational movement assessment protocols for pediatric SCI.
Purpose:
To examine the reliability of an observational movement assessment in infants and children with spinal cord injury (SCI) by evaluating interrater agreement of joint actions assessed in the International Standards for Neurological Classification of Spinal Cord Injury using the Active Movement Scale testing technique and scoring criteria.
Methods:
A series of 5 consecutive children with SCI aged 12 months to 4 years were enrolled in this pilot study to evaluate interrater agreement of observational movement.
Results:
There was high agreement of examination scores for unimpaired muscles and completely paralyzed muscles in strength comparisons between the 2 examiners. There was much less agreement of examination scores of partially intact muscles.
Conclusion:
Observational movement assessment may be one component of assessing motor function in infants and toddlers with SCI, but additional work must be done.
