Validity and Reliability of the Wall Arm Reaching Test in Children with Unilateral Cerebral Palsy
Merle Matijsen1,2, Cheriel Hofstad1, Pauline Aarts1
1Department of Research, Sint Maartenskliniek, Nijmegen, The Netherlands.
Insights
The Wall Arm Reaching Test (WART) is a valid and reliable tool for assessing arm reaching in children with unilateral cerebral palsy (uCP) in clinical and home settings. It shows good discriminatory ability for affected vs. unaffected arms and between groups.
Area of Science:
- Pediatric Rehabilitation
- Motor Control and Biomechanics
- Clinical Assessment Tools
Background:
- Assessing reaching ability in children with unilateral cerebral palsy (uCP) is crucial for intervention planning.
- Existing clinical and home-based assessments for reaching are often not quick or user-friendly.
- There is a need for a reliable and valid tool to evaluate reaching in children with uCP.
Purpose of the Study:
- To evaluate the validity, discriminatory ability, and reliability of the Wall Arm Reaching Test (WART).
- To establish the WART as a user-friendly assessment for clinical and home use in children with uCP.
Main Methods:
- The study involved 43 children with typical development (TD) and 28 children with uCP (aged 10-18 years).
- Participants performed the WART, alternating rapid touches between their hip and a wall target.
- Reliability was assessed through multiple on-site and one home-based WART administration.
- Validity was examined by correlating WART scores with a subset of the Melbourne assessment (MA2-reach) in the uCP group.
Main Results:
- The WART showed good validity, with a significant correlation to the MA2-reach (Spearman's rs=0.66).
- The test demonstrated strong discriminatory ability, differentiating between unaffected and affected arms (p < 0.001) and between TD and uCP groups (p < 0.001).
- Intraclass correlation coefficients (ICCs) for reliability ranged from 0.72-0.93 for uCP and 0.39-0.92 for TD.
Conclusions:
- The WART is a valid and reliable tool for assessing reaching in children with uCP in both clinical and home environments.
- The WART exhibits good discriminatory power for affected vs. unaffected limbs and between typically developing and uCP groups.
- While reliable for uCP, the WART's home-based reliability was poor for children with typical development.
Aims:
Assessing reaching in children with unilateral cerebral palsy (uCP) is important, but no suitable quick and easy test exists for the clinic and home. This study aimed to evaluate the validity, discriminatory ability, and reliability of the Wall Arm Reaching Test (WART), a user-friendly reaching assessment.
Methods:
43 children with typical development (TD) and 28 children with uCP (10-18 years) participated. During the WART, they alternated rapidly between touching their hip and a wall-mounted target at their height for 30 s. For reliability, children completed the WART three times on-site (twice with the same examiner) and once at home, evaluated with intraclass correlation coefficients (ICC) and Bland-Altman plots. For validity, the uCP group performed a subset of the Melbourne assessment (MA2-reach).
Results:
The WART demonstrated good validity, correlating with the MA2-reach (Spearman's rs=0.66). It showed strong discriminatory ability, with significant higher scores for the unaffected versus affected arm (p < 0.001), and for the TD group compared to the uCP group (p < 0.001). Reliability ICCs ranged from 0.72-0.93 for uCP and 0.39-0.92 for TD.
Conclusions:
The WART is a valid, reliable tool for assessing reaching in uCP in clinical and home environment, but poorly reliable at home in children with TD.
