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ACTIVLIM-CP a new Rasch-built measure of global activity performance for children with cerebral palsy
Yannick Bleyenheuft1, Julie Paradis2, Anne Renders3
1Institute of NeuroScience, Université catholique de Louvain, Brussels, Belgium.
Insights
A new tool, ACTIVLIM-CP, reliably measures combined upper and lower extremity function in children with cerebral palsy (CP). This scale aids in tracking neurorehabilitation progress for children with CP.
Area of Science:
- Pediatrics
- Rehabilitation Medicine
- Biostatistics
Background:
- Children with cerebral palsy (CP) often exhibit combined upper extremity (UE) and lower extremity (LE) impairments.
- Existing clinical tools often assess UE and LE functions in isolation, failing to capture integrated activity performance crucial for daily life.
- There is a need for a comprehensive tool to evaluate global activity performance in children with CP.
Purpose of the Study:
- To develop and validate a clinical tool for measuring global activity performance in children with CP.
- To utilize the Rasch model for the development of a unidimensional scale assessing combined UE and LE function.
Main Methods:
- Caregivers of 226 children with CP (aged 2-18 years) completed a 154-item questionnaire.
- A subset of 129 caregivers re-completed the questionnaire within 4-6 weeks to assess reproducibility.
- Data were analyzed using Rasch analysis with RUMM2020 software.
Main Results:
- A 43-item scale, ACTIVLIM-CP, was finalized, demonstrating high reliability (R=0.98) and reproducibility (R=0.97).
- The item difficulty hierarchy remained consistent across different ages, genders, and clinical forms of CP.
- The scale is suitable for monitoring children aged 2 to 18 years.
Conclusions:
- ACTIVLIM-CP is a reliable, unidimensional scale for assessing global activity performance in children with CP.
- This tool can effectively track changes in children with CP undergoing neurorehabilitation, particularly interventions targeting combined UE and LE function.
- Further research is needed to evaluate the responsiveness of the ACTIVLIM-CP scale.
Objective:
Children with cerebral palsy (CP) often have upper extremity (UE) and lower extremity (LE) impairments. While tools measuring separately UE and LE abilities are currently used, activities in which UE and LE are used in combination - numerous in everyday life - cannot be assessed because no instrument allows capturing global activity performance in children with CP. This study aimed to develop a clinical tool for measuring their global activity performance using the Rasch model.
Study Design:
The caregivers of 226 children with CP (2-18 years old) answered a 154-item experimental questionnaire. Within 4-6 weeks, 129 of them filled in the questionnaire a second time. Responses were analyzed using the Rasch RUMM2020 software.
Results:
The final 43 item scale presented a high reliability (R=0.98) and reproducibility (R=0.97). The item difficulty hierarchy was consistent over time and did not vary according to age, gender, or clinical form, allowing the follow-up of children from 2 to 18 years old.
Conclusions:
ACTIVLIM-CP is a unidimensional scale specifically developed to measure global activity performance in children with CP providing a reliable tool to follow children's evolution and document changes related to neurorehabilitation, especially where a combination of UE and LE is targeted. Its responsiveness is still to be tested.
