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Bimanual Capacity of Children With Cerebral Palsy: Intra- and Interrater Reliability of a Revised Edition of the
Ann-Kristin G Elvrum1,2, Eva Beckung3, Rannei Sæther2,4
1a Department of Clinical Services , St. Olavs Hospital, Trondheim University Hospital , Trondheim , Norway.
Insights
The revised Bimanual Fine Motor Function (BFMF 2) classification demonstrates high reliability for assessing fine motor skills in children with cerebral palsy (CP). This tool is practical for both research and clinical use.
Area of Science:
- Pediatric Rehabilitation
- Neuroscience
- Motor Control
Background:
- Cerebral palsy (CP) significantly impacts children's fine motor capacity.
- Accurate assessment tools are crucial for effective intervention and research.
- The original Bimanual Fine Motor Function (BFMF) required refinement for enhanced usability.
Purpose of the Study:
- To develop and validate a revised Bimanual Fine Motor Function (BFMF 2) classification.
- To establish the intra- and inter-rater reliability of the BFMF 2.
- To provide a reliable tool for assessing fine motor capacity in children with CP.
Main Methods:
- An expert panel revised the original BFMF, incorporating figures and explanatory text.
- Four professionals assessed the fine motor function of 79 children (3-17 years) with diverse CP subtypes and Manual Ability Classification levels (I-V).
- Intra- and inter-rater reliability were evaluated using intra-class correlation coefficient (ICC) and Cohen's quadratic weighted kappa.
Main Results:
- The overall intra-class correlation coefficient (ICC) was 0.86.
- Cohen's weighted kappa indicated high intra-rater reliability (>0.90).
- Cohen's weighted kappa indicated high inter-rater reliability (>0.85).
Conclusions:
- The revised BFMF 2 exhibits high intra- and inter-rater reliability.
- Classification is feasible using short video recordings (<5 minutes) and the BFMF 2's detailed descriptions and figures.
- The BFMF 2 is a potentially feasible and valuable tool for assessing fine motor capacity in pediatric CP research and clinical practice.
Aims:
To develop a revised edition of the Bimanual Fine Motor Function (BFMF 2), as a classification of fine motor capacity in children with cerebral palsy (CP), and establish intra- and interrater reliability of this edition.
Methods:
The content of the original BFMF was discussed by an expert panel, resulting in a revised edition comprising the original description of the classification levels, but in addition including figures with specific explanatory text. Four professionals classified fine motor function of 79 children (3-17 years; 45 boys) who represented all subtypes of CP and Manual Ability Classification levels (I-V). Intra- and inter-rater reliability was assessed using overall intra-class correlation coefficient (ICC), and Cohen's quadratic weighted kappa.
Results:
The overall ICC was 0.86. Cohen's weighted kappa indicated high intra-rater (кw: >0.90) and inter-rater (кw: >0.85) reliability.
Conclusions:
The revised BFMF 2 had high intra- and interrater reliability. The classification levels could be determined from short video recordings (<5 minutes), using the figures and precise descriptions of the fine motor function levels included in the BFMF 2. Thus, the BFMF 2 may be a feasible and useful classification of fine motor capacity both in research and in clinical practice.
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