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Computerized Adaptive Tests Detect Change Following Orthopaedic Surgery in Youth with Cerebral Palsy.

M J Mulcahey¹, Mary D Slavin², Pengsheng Ni²

¹Department of Occupational Therapy, School of Health Professions, Thomas Jefferson University, 901 Walnut Street, Philadelphia, PA 19107.

The Journal of Bone and Joint Surgery. American Volume

|September 18, 2015

Summary

The Lower Extremity/Mobility Cerebral Palsy Computerized Adaptive Test (LE CP-CAT) better detects mobility changes after surgery in children with cerebral palsy (CP). It shows greater sensitivity than other common measures, particularly for certain functional levels.

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Evaluating Postural Control and Lower-extremity Muscle Activation in Individuals with Chronic Ankle Instability

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Published on: September 18, 2020

Area of Science:

Pediatric Orthopaedics
Rehabilitation Medicine
Clinical Outcomes Assessment

Background:

Cerebral palsy (CP) significantly impacts mobility and daily function in children.
Assessing functional changes after interventions is crucial for patient care and research.
Existing outcome measures may have limitations in detecting subtle functional improvements.

Purpose of the Study:

To evaluate the sensitivity of the Lower Extremity/Mobility Cerebral Palsy Computerized Adaptive Test (LE CP-CAT) in detecting changes in mobility post-orthopaedic surgery.
To compare the LE CP-CAT's responsiveness to established measures like the Pediatric Outcomes Data Collection Instrument (PODCI) and the Timed "Up & Go" (TUG) test.

Main Methods:

A multicenter, longitudinal study involving 255 children (4-20 years) with CP (GMFCS levels I-III).
LE CP-CAT, PODCI (Transfer/Mobility and Sports/Physical Functioning domains), and TUG were administered pre- and post-surgery.
Standardized Response Means (SRMs) were calculated at 6, 12, and 24 months post-surgery.

Main Results:

LE CP-CAT demonstrated significantly higher SRMs compared to PODCI (Transfer/Mobility and Sports/Physical Functioning) at 12 months.
LE CP-CAT showed greater improvement detection than PODCI at 12 and 24 months across all GMFCS levels combined.
The LE CP-CAT outperformed PODCI for GMFCS levels I and III, but all scales showed limited performance for GMFCS level II.

Conclusions:

The LE CP-CAT is a sensitive tool for measuring functional mobility changes after orthopaedic surgery in children with CP.
It exhibits superior responsiveness compared to the PODCI and TUG tests in this population.
Further research may be needed to optimize assessment for children with GMFCS level II CP.