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Bimanual Fine Motor Function (BFMF) Classification in Children with Cerebral Palsy: Aspects of Construct and Content
Ann-Kristin G Elvrum1,2, Guro L Andersen2,3, Kate Himmelmann4
1a Department of Clinical Services , St. Olavs University Hospital , Trondheim , Norway.
Insights
The Bimanual Fine Motor Function (BFMF) classification shows strong construct validity when compared to the Manual Ability Classification System (MACS). This validation supports its use in cerebral palsy research, especially for assessing fine motor capacity.
Area of Science:
- Neurology
- Pediatrics
- Rehabilitation Medicine
Background:
- The Bimanual Fine Motor Function (BFMF) is the primary hand function classification used by the Surveillance of Cerebral Palsy in Europe (SCPE) register.
- Despite its use in epidemiological studies, the BFMF has not undergone validation.
Purpose of the Study:
- To validate the Bimanual Fine Motor Function (BFMF) by examining its construct and content validity.
- To assess the BFMF's utility in describing fine motor abilities in children with cerebral palsy.
Main Methods:
- Construct validity was evaluated by comparing BFMF with the Manual Ability Classification System (MACS) using data from 539 children (aged 4-12).
- Content validity was appraised via literature review and comparison with the International Classification of Functioning, Disability and Health - Children and Youth version (ICF-CY).
Main Results:
- A high correlation (Spearman's rho = 0.89) between BFMF and MACS supports the construct validity of the BFMF.
- The BFMF items (hold, grasp, manipulate) are relevant for describing fine motor abilities, but its classification of capacity versus performance is unclear.
- Comparison with ICF-CY highlighted the relevance of BFMF items for children with cerebral palsy.
Conclusions:
- The BFMF demonstrates strong construct validity and may offer complementary information to the MACS.
- The BFMF is particularly valuable when interpreted as a classification of fine motor capacity, enhancing understanding of hand function in cerebral palsy.
Unlabelled:
The Bimanual Fine Motor Function (BFMF) is currently the principal classification of hand function recorded by the Surveillance of Cerebral Palsy in Europe (SCPE) register. The BFMF is used in a number of epidemiological studies, but has not yet been validated.
Aims:
To examine aspects of construct and content validity of the BFMF.
Methods And Results:
Construct validity of the BFMF was assessed by comparison with the Manual Ability Classification System (MACS) using register-based data from 539 children born 1999-2003 (304 boys; 4-12 years). The high correlation with the MACS (Spearman's rho = 0.89, CI: 0.86-0.91, p<.001) supports construct validity of the BFMF. The content of the BFMF was appraised through literature review, and by using the ICF-CY as a framework to compare the BFMF and MACS. The items hold, grasp and manipulate were found to be relevant to describe increasingly advanced fine motor abilities in children with CP, but the description of the BFMF does not state whether it is a classification of fine motor capacity or performance.
Conclusion:
Our results suggest that the BFMF may provide complementary information to the MACS regarding fine motor function and actual use of the hands, particularly if used as a classification of fine motor capacity.
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