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Published on: November 3, 2016
Functional strength measurement in cerebral palsy: feasibility, test-retest reliability, and construct validity
Wendy Aertssen1, Ellen Smulders1, Bouwien Smits-Engelsman2
1Avans Plus , Breda , Netherlands.
Insights
A new Functional Strength Measurement for children with cerebral palsy (CP) is feasible, reliable, and valid. This tool aids in the physical examination of children with CP.
Area of Science:
- Pediatrics
- Neurology
- Rehabilitation Medicine
Background:
- Children with cerebral palsy (CP) lack a standardized tool to measure functional strength across both upper and lower extremities.
- Existing assessment methods may not adequately capture the functional strength deficits specific to CP.
- The development of a specialized instrument is crucial for effective clinical practice and rehabilitation planning.
Purpose of the Study:
- To evaluate the feasibility, test-retest reliability, and validity of the Functional Strength Measurement for Children with Cerebral Palsy (FSM-CP).
- To establish a reliable and valid instrument for assessing functional strength in pediatric CP populations.
- To provide a practical tool for clinicians examining children with CP.
Main Methods:
- The study involved thirty-seven children diagnosed with cerebral palsy (CP), aged 4-10 years, classified under Gross Motor Function Classification System (GMFCS) levels I and II.
- The Functional Strength Measurement for Children with Cerebral Palsy (FSM-CP) underwent standardization of items, with one item removed based on common CP-related compensations.
- Test-retest reliability was assessed, and convergent validity was determined by correlating FSM-CP scores with isometric muscle strength measured using a handheld dynamometer (HHD).
Main Results:
- The FSM-CP demonstrated high test-retest reliability across all measured items, with intra-class correlation coefficients (ICCs) ranging from 0.79 to 0.95.
- Significant correlations were found between the FSM-CP and handheld dynamometer (HHD) measurements, with correlation coefficients (r) ranging from 0.36 to 0.75.
- These findings indicate a strong agreement between the new functional measure and objective strength assessments.
Conclusions:
- The Functional Strength Measurement for Children with Cerebral Palsy (FSM-CP) is a feasible, reliable, and valid tool for use in this population.
- The FSM-CP can be effectively integrated into the clinical practice for the physical examination of children with CP.
- This instrument offers a valuable addition to the assessment repertoire for pediatric rehabilitation specialists.
Abstract:
Purpose: No instrument exists that measures functional strength in both lower and upper extremities in children with cerebral palsy (CP). Therefore, the functional strength measurement (FSM) was tested for feasibility, test-retest reliability and validity in CP. Methods: Thirty-seven children with CP (aged 4-10 years, Gross Motor Function Classification System I and II) participated. The most common compensations for CP were described; new item descriptions were standardized, and one item was removed. Test-retest reliability was examined. To measure convergent validity, correlations between the FSM-CP and isometric muscle strength measured with the handheld dynamometer (HHD) were determined. Results: Test-retest reliability was considered high for all items (intra-class correlation coefficient 0.79-0.95). Significant correlations between the HHD and FSM-CP ranged from r = 0.36 to 0.75. Conclusion: The FSM-CP is feasible, reliable, and valid to use in children with CP. The FSM-CP can be considered as a helpful tool in clinical practice of physical examination of children with CP.
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