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Event-related Potentials During Target-response Tasks to Study Cognitive Processes of Upper Limb Use in Children with Unilateral Cerebral Palsy
Published on: January 11, 2016
Reliable classification of functional profiles and movement disorders of children with cerebral palsy
Melinda Randall1, Adrienne Harvey, Christine Imms
1Department of Developmental Medicine, The Royal Children's Hospital and Murdoch Children's Research Institute, Melbourne, Australia. melinda.randall@rch.org.au
Insights
The Communication Function Classification System (CFCS), Bimanual Fine Motor Function (BFMF), Surveillance of Cerebral Palsy in Europe (SCPE), and Gross Motor Function Classification System (GMFCS) show high inter-rater reliability. These tools are reliable for clinical and research use in children with cerebral palsy.
Area of Science:
- Pediatric Neurology
- Rehabilitation Medicine
- Developmental Pediatrics
Background:
- Cerebral palsy (CP) and periventricular white matter injury (PWMI) impact motor and communication functions in children.
- Standardized classification systems are crucial for consistent assessment and management of CP.
- Evaluating the reliability of these tools is essential for their valid application.
Purpose of the Study:
- To assess the inter-rater reliability of four key classification systems: CFCS, BFMF, SCPE, and GMFCS.
- To determine the consistency of classifications made by different raters for children with CP and PWMI.
- To support the routine clinical and research application of these tools.
Main Methods:
- Twenty children (aged 4-11 years) with CP and PWMI participated.
- Two independent raters assessed each child using CFCS, BFMF, SCPE, and GMFCS.
- Kappa statistics were employed to quantify inter-rater agreement.
Main Results:
- High inter-rater reliability was observed for CFCS, BFMF, and GMFCS (Kappa = 0.98).
- The SCPE classification tree demonstrated good inter-rater reliability (Kappa = 0.84).
- Parental ratings on the Manual Ability Classification System (MACS) were also collected.
Conclusions:
- The studied classification systems (CFCS, BFMF, SCPE, GMFCS) exhibit robust inter-rater reliability.
- These findings support the consistent use of these tools in clinical practice and research settings.
- The reliability of these systems, alongside MACS, aids in standardized patient assessment and outcome tracking.
Objective:
To examine the inter-rater reliability of the Communication Function Classification System (CFCS), Bimanual Fine Motor Function (BFMF), Surveillance of Cerebral Palsy in Europe (SCPE) classification tree, and Gross Motor Function Classification System (GMFCS) in children with cerebral palsy (CP) and periventricular white matter injury (PWMI) aged 4-11 years.
Method:
Twenty children were assessed by two raters using the four tools, in addition parents undertook ratings on the Manual Ability Classification System (MACS). Kappa statistics were used to calculate the level of agreement between raters' classifications.
Results:
Participants comprised 12 males and 8 females with CP and PWMI, mean age 8 years 1 month (standard deviation 2 years 3 months). Inter-rater reliability across the four tools was 0.98 (CFCS, BFMF, and GMFCS) and 0.84 (SCPE).
Implications:
These findings suggest that these four tools are reasonably robust to inter-rater variability supporting their routine use along with the MACS in clinical and research applications.
