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Dutia I, Eres R, Sawyer SM, Pennacchia J, Johnston LM, Cleary S, Reddihough D, Coghill D. Fatigue experienced by people with cerebral palsy: a systematic review of assessment tools and decision tree. Disabil Rehabil 2024; 46:1751-1759. [PMID: 37158234 DOI: 10.1080/09638288.2023.2205175] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 04/14/2023] [Indexed: 05/10/2023]
Abstract
PURPOSE To conduct a systematic review of self- and proxy-report fatigue assessment tools used in studies of people with cerebral palsy (CP) of all ages, and to develop a fatigue assessment tool decision tree for clinicians and researchers. MATERIALS AND METHODS Five electronic databases (MEDLINE, PsycInfo, CINAHL, Web of Science and Cochrane) were searched to September 2021 to identify studies assessing self-reported fatigue in people with CP of any age. The assessment tools utilised were extracted and two reviewers appraised the tool characteristics, clinical utility and psychometric properties. A decision tree for selecting fatigue assessment tools was constructed. RESULTS Ten assessment tools were identified across thirty-nine studies, three of which are valid and reliable for assessing fatigue severity and impact in people with CP. A four-level fatigue assessment tool decision tree was constructed. No valid and reliable tool for assessing cognitive fatigue was identified; responsiveness has not been evaluated in any tool for people with CP. CONCLUSIONS Physical fatigue screening and assessment tools for people with CP are available and are presented in our decision tree, however their utility as outcome measures remains unclear. Cognitive fatigue is understudied and poorly understood, further work is required in this area.
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Affiliation(s)
- Iain Dutia
- School of Human Movement and Nutrition Science, University of Queensland, Brisbane, Australia
- School of Allied Health, Australian Catholic University, Brisbane, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia
- Neurodisability and Rehabilitation, Murdoch Children's Research Institute, Melbourne, Australia
| | - Robert Eres
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia
- Neurodisability and Rehabilitation, Murdoch Children's Research Institute, Melbourne, Australia
- School of Health and Biomedical Science, Royal Melbourne Institute of Technology, Melbourne, Australia
| | - Susan M Sawyer
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia
- Neurodisability and Rehabilitation, Murdoch Children's Research Institute, Melbourne, Australia
| | - Jacinta Pennacchia
- Neurodisability and Rehabilitation, Murdoch Children's Research Institute, Melbourne, Australia
- School of Health and Biomedical Science, Royal Melbourne Institute of Technology, Melbourne, Australia
- School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Leanne M Johnston
- School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia
| | - Stacey Cleary
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia
- Neurodisability and Rehabilitation, Murdoch Children's Research Institute, Melbourne, Australia
| | - Dinah Reddihough
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia
- Neurodisability and Rehabilitation, Murdoch Children's Research Institute, Melbourne, Australia
| | - David Coghill
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia
- Neurodisability and Rehabilitation, Murdoch Children's Research Institute, Melbourne, Australia
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Toussaint‐Duyster LCC, Cammen‐van Zijp MHM, Tibboel D, Gischler S, Rosmalen J, IJsselstijn H. A parent-reported standardised checklist is not sensitive to screen for motor problems at school age following neonatal critical illness. Acta Paediatr 2020; 109:1801-1806. [PMID: 31991011 PMCID: PMC7496489 DOI: 10.1111/apa.15192] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 01/17/2020] [Accepted: 01/22/2020] [Indexed: 01/03/2023]
Abstract
AIM As nowadays more children survive neonatal critical illness, evaluation of long-term morbidities becomes more important. We determined whether the parent-reported Movement Assessment Battery for Children-Second Edition (MABC-2) Checklist is a proper tool to screen for motor problems in school-aged children born with severe anatomical anomalies and/or treated with neonatal extracorporeal membrane oxygenation. METHODS We analysed data of 190/253 children (60.0% male) participating in our multidisciplinary follow-up programme who were routinely assessed at the ages of five, eight and/or 12 years. Parents completed the Checklist prior to assessment of the child's actual motor performance by a physical therapist using the MABC-2 Test. The sensitivity and specificity of the Checklist with a cut-off point of the 16th percentile were determined. RESULTS The sensitivity of the MABC-2 Checklist was 57.1%, which implies that 42.9% of the children at risk for motor problems were not identified. The specificity was 79.1%. CONCLUSION The low sensitivity of the MABC-2 Checklist suggests that this instrument does not suffice to screen for motor problems in children who survived neonatal critical illness. Yet, it may help to gain insight in parental perceptions of the child's motor performance and to provide tailored advice on lifestyle.
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Affiliation(s)
- Leontien C. C. Toussaint‐Duyster
- Department of Pediatric Surgery and Intensive Care Erasmus MC‐Sophia Children's Hospital Rotterdam The Netherlands
- Department of Orthopedics Section of Physical Therapy Erasmus MC‐Sophia Children's Hospital Rotterdam The Netherlands
| | - Monique H. M. Cammen‐van Zijp
- Department of Pediatric Surgery and Intensive Care Erasmus MC‐Sophia Children's Hospital Rotterdam The Netherlands
- Department of Orthopedics Section of Physical Therapy Erasmus MC‐Sophia Children's Hospital Rotterdam The Netherlands
| | - Dick Tibboel
- Department of Pediatric Surgery and Intensive Care Erasmus MC‐Sophia Children's Hospital Rotterdam The Netherlands
| | - Saskia Gischler
- Department of Pediatric Surgery and Intensive Care Erasmus MC‐Sophia Children's Hospital Rotterdam The Netherlands
| | - Joost Rosmalen
- Department of Biostatistics Erasmus MC Rotterdam The Netherlands
| | - Hanneke IJsselstijn
- Department of Pediatric Surgery and Intensive Care Erasmus MC‐Sophia Children's Hospital Rotterdam The Netherlands
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The Cerebral Palsy Profile of Health and Function: Upper-Extremity Domain's Sensitivity to Change Following Musculoskeletal Surgery. J Hand Surg Am 2019; 44:274-287. [PMID: 30733101 DOI: 10.1016/j.jhsa.2018.12.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2018] [Revised: 09/19/2018] [Accepted: 12/07/2018] [Indexed: 02/02/2023]
Abstract
PURPOSE The Cerebral Palsy Profile of Health and Function (CP-PRO) Computerized Adaptive Tests (CAT) are quality of life measures developed specifically for use in children with cerebral palsy. This study examined the ability of the upper-extremity (UE) CP-PRO CAT to detect change in function after UE surgery compared with the Pediatric Outcomes Data Collection Instrument (PODCI), ABILHAND-Kids, and Box and Blocks test. METHODS From 2009 to 2013, children with cerebral palsy who had UE musculoskeletal surgery completed the UE CP-PRO CAT, PODCI-UE, ABILHAND-Kids, and Box and Blocks tests before surgery (97 children) and at 3 postoperative intervals: 6 months (80 children), 12 months (73 children), and 24 months (52 children). Mean, SD, effect size (ES), and standardized response mean (SRM) values for each measure at each time interval and each level of the Manual Ability Classification System were calculated and compared. Finally, the minimal detectable change at the 90% confidence level was determined. RESULTS Values for the ES (0.40) and SRM (0.53) for the UE CP-PRO CAT at baseline to 6 months were moderate and significantly greater than the PODCI-UE (ES, 0.18; SRM, 0.25). The ES and SRM for the PODCI-UE, ABILHAND-Kids, and Box and Blocks tests were not significantly greater than for the UE CP-PRO CAT at any period. From baseline to 6 months, the UE CP-PRO CAT detected a large and significant improvement for Manual Ability Classification System level II (SRM, 0.70; ES, 0.70). The minimal detectable change for the UE CP-PRO CAT was 5.20. CONCLUSIONS The UE CP-PRO CAT is significantly better in detecting change in UE function in the first 6 months after surgery and is comparable to other measures at 12 and 24 months. TYPE OF STUDY/LEVEL OF EVIDENCE Diagnostic II.
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Fischer KI, Barthel D, Otto C, Ravens-Sieberer U, Thyen U, Klein M, Walter O, Rose M, Nolte S. Minimal Associations Between Clinical Data and Children's Self-Reported Health-Related Quality of Life in Children With Chronic Conditions-A Cross-Sectional Study. Front Pediatr 2019; 7:17. [PMID: 30805321 PMCID: PMC6370724 DOI: 10.3389/fped.2019.00017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 01/15/2019] [Indexed: 12/31/2022] Open
Abstract
Introduction: The improvement-or at least maintenance-of health-related quality of life (HRQoL) in children and adolescents is one of the main aims of chronic disease care. This study examines HRQoL of children and adolescents with three different chronic conditions (i.e., diabetes mellitus, asthma, juvenile arthritis) using the computer-adaptive test Kids-CAT, comprising five HRQoL domains: physical well-being, psychological well-being, parent relations, social support and peers, and school well-being. Further, associations between HRQoL and distinct clinical data and medical assessments are investigated to explore how much variability of the five domains can be explained by these variables. Methods: Cross-sectional data of the Kids-CAT study was analyzed. The Kids-CAT was used in two outpatient clinics in northern Germany gathering data on self-reported HRQoL in n = 309 children and adolescents aged 7-17 years. Additionally, general patient information, clinical data, and pediatrician-reported medical assessments were measured. Multiple regression analyses were conducted to explore associations between HRQoL and selected variables (i.e., disease duration, co-morbidity, disease control, overall health status). Results: Overall, self-reported HRQoL in all five domains were comparable to data of an age- and sex-matched reference population. Results of regression analyses indicated that the investigated variables only minimally explain variance in the five Kids-CAT domains. Sociodemographic, clinical data, and medical assessments explained 18.4% of the variance in physical well-being, 10.7% in psychological well-being, and < 10% of the variance in parent relations, social support and peers, and school well-being. Conclusion: Sociodemographic data, disease duration, co-morbidity, and medical assessments, such as disease control or pediatrician-assessed overall health status show low association with HRQoL of children and adolescents with chronic conditions. Data on self-reported HRQoL delivers valuable information on children's well-being and can improve healthcare professionals' understanding of the subjective well-being of their young patients. The implementation of tools like the Kids-CAT can facilitate the identification of potential problem areas, which should enable healthcare professionals to better address specific healthcare needs. Clinical Trial Registration: identifier: DRKS00006326 (retrospectively registered); Date of registry: August 1st, 2014.
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Affiliation(s)
- Kathrin I Fischer
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Medical Department, Division of Psychosomatic Medicine, Berlin, Germany
| | - Dana Barthel
- Research Unit Child Public Health, Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christiane Otto
- Research Unit Child Public Health, Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ulrike Ravens-Sieberer
- Research Unit Child Public Health, Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ute Thyen
- Department of Pediatric and Adolescent Medicine, Universität zu Lübeck, Lübeck, Germany
| | - Marcus Klein
- Department of General Pediatrics, Christian-Albrechts-Universität, Kiel, Germany
| | - Otto Walter
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Medical Department, Division of Psychosomatic Medicine, Berlin, Germany
| | - Matthias Rose
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Medical Department, Division of Psychosomatic Medicine, Berlin, Germany.,Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States
| | - Sandra Nolte
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Medical Department, Division of Psychosomatic Medicine, Berlin, Germany.,Public Health Innovation, Population Health Strategic Research Centre, School of Health and Social Development, Deakin University, Geelong, VIC, Australia
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Shore BJ, Allar BG, Miller PE, Matheney TH, Snyder BD, Fragala-Pinkham M. Measuring the Reliability and Construct Validity of the Pediatric Evaluation of Disability Inventory–Computer Adaptive Test (PEDI-CAT) in Children With Cerebral Palsy. Arch Phys Med Rehabil 2019; 100:45-51. [DOI: 10.1016/j.apmr.2018.07.427] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 05/28/2018] [Accepted: 07/03/2018] [Indexed: 12/26/2022]
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Saleh E, Dahan-Oliel N, Montpetit K, Benaroch T, Yap R, Barakat N, Mulcahey MJ. Functional Gains in Children With Spastic Hemiplegia Following a Tendon Achilles Lengthening Using Computerized Adaptive Testing-A Pilot Study. Child Neurol Open 2018; 5:2329048X18811452. [PMID: 30456216 PMCID: PMC6238195 DOI: 10.1177/2329048x18811452] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 08/30/2018] [Accepted: 10/14/2018] [Indexed: 11/17/2022] Open
Abstract
Purpose: This pilot study evaluated the outcomes of tendon Achilles lengthening in 12 children (mean age: 11.2 years) with spastic hemiplegia. Methods: Cerebral Palsy Computer Adaptive Tests, the timed up-and-go, the Gross Motor Function Measure, the Gillette Functional Assessment Questionnaire, and the Pediatric Outcomes Data Collection Instrument were administered at baseline and at 6, 12, and 24 months postsurgery. Results: Significant improvement at the latest follow-up (12-24 months following surgery) was seen in all domains of the Cerebral Palsy Computer Adaptive Test: activity (P = .017), lower extremity (P = .005), global (P = .005), pain (P = .005), and fatigue (P = .028), as well as in the Gross Motor Function Measure-standing domain (P = .02) and the mobility domain of the Pediatric Outcomes Data Collection Instrument (P = .04). Conclusion: These findings indicate that the tendon Achilles lengthening improved functional outcome in these children as measured by tests of physical function, walking speed, and activity performance.
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Affiliation(s)
- Eli Saleh
- Université de Montréal, Montreal, Quebec, Canada
| | - Noémi Dahan-Oliel
- Shriners Hospital for Children, School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada
| | | | | | - Rita Yap
- Shriners Hospital for Children, Montreal, Quebec, Canada
| | - Nadia Barakat
- Shriners Hospitals for Children, Philadelphia, PA, USA
| | - M J Mulcahey
- Shriners Hospitals for Children, Jefferson School of Health Professions, Thomas Jefferson University, Philadelphia, PA, USA
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Mulcahey MJ, Slavin MD, Pengsheng N, Kratz A, Kisala PA, Tulsky DS, Jette AM. Examination of psychometric properties of PROMIS®: Pediatric upper limb measures in youth with cerebral palsy. Br J Occup Ther 2018. [DOI: 10.1177/0308022618757961] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Introduction This study examines the validity and distribution characteristics of the PROMIS® pediatric upper limb measures in a sample of young people with cerebral palsy. Method Data are a cross-sectional subset of a larger prospective study of the responsiveness to change of PROMIS® pediatric measures following surgery to improve functioning in young people with cerebral palsy. Ninety-three participants between the ages of eight and 21 years completed the PROMIS® pediatric mobility and upper limb computer adaptive tests and short forms in conjunction with a set of static “legacy” measures of physical functioning, including a parent-report of upper limb function. Results The PROMIS® Pediatric upper limb short form demonstrated acceptable internal consistency (Cronbach’s alpha = 0.85). PROMIS® pediatric upper limb computer adaptive tests and short form mean values (42.1(11) and 43(10.4), respectively) were nearly 1 SD below normal, which is appropriate when a generic measure is used in a sample of young persons with cerebral palsy. The PROMIS® pediatric upper limb computer adaptive tests had a higher frequency of ceiling effects (29.50%) compared to the short form (18.30%). Conclusion Results of this study suggest that the PROMIS® pediatric upper limb computer adaptive tests and the short form are valid indicators of upper limb function in young people with cerebral palsy. The item bank can be replenished to address ceiling effects.
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Affiliation(s)
- Mary Jane Mulcahey
- Professor of Occupational Therapy, Jefferson College of Health Professions, Thomas Jefferson University, USA
| | - Mary D Slavin
- Research Scientist, Law, Policy and Management, Boston University School of Public Health, USA
| | - Ni Pengsheng
- Statistician, Law, Policy and Management, Boston University School of Public Health, USA
| | - Anna Kratz
- Assistant Professor, Institute for Health Care Policy and Innovation, University of Michigan, USA
| | - Pamela A Kisala
- Associate Scientist, Center on Assessment Research and Translation, University of Delaware, USA
| | - David S Tulsky
- Professor, Departments of Physical Therapy and Psychological and Brain Sciences, University of Delaware, USA
| | - Alan M Jette
- Professor, Rehabilitation Sciences, MGH Institute of Health Professions, Boston, MA, USA
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Damiano DL, Stanley CJ, Ohlrich L, Alter KE. Task-Specific and Functional Effects of Speed-Focused Elliptical or Motor-Assisted Cycle Training in Children With Bilateral Cerebral Palsy: Randomized Clinical Trial. Neurorehabil Neural Repair 2017; 31:736-745. [PMID: 28691601 DOI: 10.1177/1545968317718631] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Locomotor training using treadmills or robotic devices is commonly utilized to improve gait in cerebral palsy (CP); however, effects are inconsistent and fail to exceed those of equally intense alternatives. Possible limitations of existing devices include fixed nonvariable rhythm and too much limb or body weight assistance. OBJECTIVE To quantify and compare effectiveness of a motor-assisted cycle and a novel alternative, an elliptical, in CP to improve interlimb reciprocal coordination through intensive speed-focused leg training. METHODS A total of 27 children with bilateral CP, 5 to 17 years old, were randomized to 12 weeks of 20 minutes, 5 days per week home-based training (elliptical = 14; cycle = 13) at a minimum of 40 revolutions per minute, with resistance added when speed target was achieved. Primary outcomes were self-selected and fastest voluntary cadence on the devices and gait speed. Secondary outcomes included knee muscle strength, and selective control and functional mobility measures. RESULTS Cadence on trained but not nontrained devices increased, demonstrating task specificity of training and increased exercise capability. Mean gait speed did not increase in either group, nor did parent-reported functional mobility. Knee extensor strength increased in both. An interaction between group and time was seen in selective control with scores slightly increasing for the elliptical and decreasing for the cycle, possibly related to tighter limb coupling with cycling. CONCLUSIONS Task-specific effects were similarly positive across groups, but no transfer was seen to gait or function. Training dose was low (≤20 hours) compared with intensive upper-limb training recommendations and may be insufficient to produce appreciable clinical change.
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Shore BJ, Allar BG, Miller PE, Matheney TH, Snyder BD, Fragala-Pinkham MA. Evaluating the Discriminant Validity of the Pediatric Evaluation of Disability Inventory: Computer Adaptive Test in Children With Cerebral Palsy. Phys Ther 2017; 97:669-676. [PMID: 28379484 DOI: 10.1093/ptj/pzx033] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Accepted: 03/16/2017] [Indexed: 12/26/2022]
Abstract
BACKGROUND The Pediatric Evaluation of Disability Inventory-Computer Adaptive Test (PEDI-CAT) is a new clinical assessment for children and youth from birth through 20 years of age. OBJECTIVE To determine the discriminant validity of the PEDI-CAT according to the Gross Motor Function Classification System (GMFCS) and Manual Ability Classification System (MACS) in children with cerebral palsy (CP). DESIGN A prospective convenience cross-sectional sample of 101 school-age children with CP was stratified by GMFCS level. METHODS Participants were excluded if they underwent recent surgery (<6 months). Receiver operating characteristics curve analysis was used to quantify the discriminant validity of the PEDI-CAT domains to distinguish the level of independence in fine and gross motor function. General linear modeling was used to assess discriminant ability across all GMFCS and MACS levels. RESULTS Mean age was 11 years, 11 months (SD 3.7). Mobility and Daily Activities domains exhibited excellent discriminant validity distinguishing between ambulatory and nonambulatory participants [area under the curve (AUC) = 0.98 and 0.97, respectively] and the Daily Activities domain exhibited excellent discriminant validity distinguishing between independent and dependent hand function (AUC = 0.93). All PEDI-CAT domains were able to discriminate between ambulatory (GMFCS levels I-III) or nonambulatory (GMFCS levels IV-V) as well as manually independent (MACS levels I-II) or manually dependent functional levels (MACS levels III-V) ( P < .001). LIMITATIONS Our convenience cross-sectional sample included school-age children with primarily Caucasian, middle-income parents and may not be representative of other cultural, socioeconomic backgrounds. Not all participants had a MACS level assigned, however, no differences were found in PEDI-CAT scores between those with and without MACS scores. CONCLUSIONS These results demonstrate that the PEDI-CAT is a valid outcome instrument for measuring functional abilities in children with CP, able to differentiate across fine and gross motor functional levels.
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Affiliation(s)
- Benjamin J Shore
- Department of Orthopedic Surgery, Boston Children's Hospital, Harvard Medical School, Hunnewell 221, 300 Longwood Ave, Boston MA 02115 (USA)
| | | | | | | | - Brian D Snyder
- Department of Orthopedic Surgery, Boston Children's Hospital
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Mulcahey MJ, Haley SM, Slavin MD, Kisala PA, Ni P, Tulsky DS, Jette AM. Ability of PROMIS Pediatric Measures to Detect Change in Children With Cerebral Palsy Undergoing Musculoskeletal Surgery. J Pediatr Orthop 2016; 36:749-56. [PMID: 26057065 PMCID: PMC4670604 DOI: 10.1097/bpo.0000000000000533] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND The Patient Reported Outcomes Measurement Information System (PROMIS) was developed to provide patient-reported outcome measures that are designed as being universally relevant across health conditions, low burden, and precise. A major problem for research and clinical practice in cerebral palsy (CP) is the void of outcomes instruments that are capable of evaluating the wide range of abilities and broad age spectrum inherent in this clinical population. Given the tremendous potential of PROMIS, the research questions for this study were "How do PROMIS pediatric computer adaptive tests and short forms detect change in children with CP following elective musculoskeletal surgery?" and "How do PROMIS instruments compare to the Pediatric Quality of Life Inventory Cerebral Palsy Module Version 3.0 (PedsQL CP), Pediatric Outcomes Data Collection Instrument (PODCI), the Timed Up and Go (TUG), and the Gross Motor Functional Measure (GMFM)." METHODS PROMIS Pediatric computer adaptive tests and short forms and the PedsQL, PODCI, TUG, and GMFM were administered before and after surgery. Effect size (ES) and standardized response mean (SRM) were calculated. Floor and ceiling effects were evaluated and, exposure rates for the PROMIS item banks were examined. RESULTS ES and SRM for all PROMIS Pediatric Measures were nonsignificant. PedsQL CP detected significant, positive change in mobility at 6 (ES=0.26; SRM=0.31) and 12 (ES=0.36; SRM=0.36) months; pain at 12 months (ES=0.29; SRM=0.34); and fatigue at 6 (ES=0.24; SRM=0.22) and 12 (ES=0.36; SRM=0.41) months. Significant negative changes were detected by the PODCI (ES=-0.20; SRM=-0.26), GMFM (ES=-0.13; SRM=-0.24), and TUG (ES=-0.29; SRM=-0.25). Ceiling effects were high. Exposure to an appropriate range of the PROMIS Mobility item bank was limited. CONCLUSIONS PROMIS measures were less able to detect change than other measures. PROMIS measures may be improved by tailoring start/stop rules or by adding items to include content appropriate for children with mobility impairments. LEVEL OF EVIDENCE Level III-diagnostic study.
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Affiliation(s)
- MJ Mulcahey
- Department of Occupational Therapy, School of Health Professions, Thomas Jefferson University, Philadelphia, PA
| | - Stephen M. Haley
- Boston University School of Public Health, Health and Disability Research Institute, Boston, MA
- Deceased
| | - Mary D. Slavin
- Boston University School of Public Health, Health and Disability Research Institute, Boston, MA
| | - Pamela A. Kisala
- Department of Physical Therapy, College of Health Sciences, University of Delaware, Newark, DE
| | - Pengsheng Ni
- Boston University School of Public Health, Health and Disability Research Institute, Boston, MA
| | - David S. Tulsky
- Department of Physical Therapy, College of Health Sciences, University of Delaware, Newark, DE
- Kessler Foundation Research Center, West Orange, NJ
| | - Alan M. Jette
- Boston University School of Public Health, Health and Disability Research Institute, Boston, MA
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Mulcahey M, Slavin MD, Ni P, Vogel LC, Kozin SH, Haley SM, Jette AM. Computerized Adaptive Tests Detect Change Following Orthopaedic Surgery in Youth with Cerebral Palsy. J Bone Joint Surg Am 2015; 97:1482-94. [PMID: 26378264 PMCID: PMC6948780 DOI: 10.2106/jbjs.o.00179] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND The Cerebral Palsy Computerized Adaptive Test (CP-CAT) is a parent-reported outcomes instrument for measuring lower and upper-extremity function, activity, and global health across impairment levels and a broad age range of children with cerebral palsy (CP). This study was performed to examine whether the Lower Extremity/Mobility (LE) CP-CAT detects change in mobility following orthopaedic surgery in children with CP. METHODS This multicenter, longitudinal study involved administration of the LE CP-CAT, the Pediatric Outcomes Data Collection Instrument (PODCI) Transfer/Mobility and Sports/Physical Functioning domains, and the Timed "Up & Go" test (TUG) before and after elective orthopaedic surgery in a convenience sample of 255 children, four to twenty years of age, who had CP and a Gross Motor Function Classification System (GMFCS) level of I, II, or III. Standardized response means (SRMs) and 95% confidence intervals (CIs) were calculated for all measures at six, twelve, and twenty-four months following surgery. RESULTS SRM estimates for the LE CP-CAT were significantly greater than the SRM estimates for the PODCI Transfer/Mobility domain at twelve months, the PODCI Sports/Physical Functioning domain at twelve months, and the TUG at twelve and twenty-four months. When the results for the children at GMFCS levels I, II, and III were grouped together, the improvements in function detected by the LE CP-CAT at twelve and twenty-four months were found to be greater than the changes detected by the PODCI Transfer/Mobility and Sports/Physical Functioning scales. The LE CP-CAT outperformed the PODCI scales for GMFCS levels I and III at both of these follow-up intervals; none of the scales performed well for patients with GMFCS level II. CONCLUSIONS The results of this study showed that the LE CP-CAT displayed superior sensitivity to change than the PODCI and TUG scales after musculoskeletal surgery in children with CP.
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Affiliation(s)
- M.J. Mulcahey
- Department of Occupational Therapy, School of Health Professions, Thomas Jefferson University, 901 Walnut Street, Philadelphia, PA 19107. E-mail address:
| | - Mary D. Slavin
- Health and Disability Research Institute, School of Public Health, Boston University, 715 Albany Street, Boston, MA 02118
| | - Pengsheng Ni
- Health and Disability Research Institute, School of Public Health, Boston University, 715 Albany Street, Boston, MA 02118
| | - Lawrence C. Vogel
- Shriners Hospitals for Children, 2211 North Oak Park Avenue, Chicago, IL 60707
| | - Scott H. Kozin
- Shriners Hospitals for Children, 3551 North Broad Street, Philadelphia, PA 19438
| | | | - Alan M. Jette
- Health and Disability Research Institute, School of Public Health, Boston University, 715 Albany Street, Boston, MA 02118
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Gerber CN, Labruyère R, van Hedel HJA. Reliability and Responsiveness of Upper Limb Motor Assessments for Children With Central Neuromotor Disorders. Neurorehabil Neural Repair 2015; 30:19-39. [PMID: 25921350 DOI: 10.1177/1545968315583723] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Background. To investigate the effectiveness of upper limb rehabilitation, sound measures of upper limb function, capacity, and performance are paramount. Objectives. This systematic review investigates reliability and responsiveness of upper limb measurement tools used in pediatric neurorehabilitation. Methods. A 2-tiered search was conducted up to July 2014. The first search identified upper limb motor assessments for 1- to 18-year-old children with neuromotor disorders. The second search examined the psychometric properties of the tools. Methodological quality was rated according to COSMIN guidelines, and results for each tool were assembled in a “best evidence synthesis.” Furthermore, we delineated whether tools were unimanual or bimanual tests and if they measured recovery or did not distinguish between physiological and compensatory movements. Results. The first search delivered 2546 hits. Of these, 110 articles on 51 upper limb assessment tools were included. The second search resulted in 58 studies on reliability, 11 on measurement error, and 10 on responsiveness. Best evidence synthesis revealed only 2 assessments with moderate positive evidence for reliability, whereas no evidence on measurement error and responsiveness was found. The Melbourne Assessment showed moderate positive evidence for interrater and a fair positive level of evidence for intrarater reliability. The Pediatric Motor Activity Log Revised revealed moderate positive evidence for test–retest reliability. Conclusions. There is a lack of high-quality studies about psychometric properties of upper limb measurement tools in children with neuromotor disorders. To date, upper limb rehabilitation trials in children and adolescents risk being biased by insensitive measurement tools lacking reliability.
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Affiliation(s)
- Corinna N. Gerber
- Rehabilitation Center for Children and Adolescents, Affoltern am Albis, Switzerland
- University Children’s Hospital Zurich, Zurich, Switzerland
- Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Rob Labruyère
- Rehabilitation Center for Children and Adolescents, Affoltern am Albis, Switzerland
- University Children’s Hospital Zurich, Zurich, Switzerland
| | - Hubertus J. A. van Hedel
- Rehabilitation Center for Children and Adolescents, Affoltern am Albis, Switzerland
- University Children’s Hospital Zurich, Zurich, Switzerland
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A new computerized adaptive test advancing the measurement of health-related quality of life (HRQoL) in children: the Kids-CAT. Qual Life Res 2014; 24:871-84. [PMID: 25307509 DOI: 10.1007/s11136-014-0812-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2014] [Indexed: 10/24/2022]
Abstract
PURPOSE Assessing health-related quality of life (HRQoL) via Computerized Adaptive Tests (CAT) provides greater measurement precision coupled with a lower test burden compared to conventional tests. Currently, there are no European pediatric HRQoL CATs available. This manuscript aims at describing the development of a HRQoL CAT for children and adolescents: the Kids-CAT, which was developed based on the established KIDSCREEN-27 HRQoL domain structure. METHODS The Kids-CAT was developed combining classical test theory and item response theory methods and using large archival data of European KIDSCREEN norm studies (n = 10,577-19,580). Methods were applied in line with the US PROMIS project. Item bank development included the investigation of unidimensionality, local independence, exploration of Differential Item Functioning (DIF), evaluation of Item Response Curves (IRCs), estimation and norming of item parameters as well as first CAT simulations. RESULTS The Kids-CAT was successfully built covering five item banks (with 26-46 items each) to measure physical well-being, psychological well-being, parent relations, social support and peers, and school well-being. The Kids-CAT item banks proved excellent psychometric properties: high content validity, unidimensionality, local independence, low DIF, and model conform IRCs. In CAT simulations, seven items were needed to achieve a measurement precision between .8 and .9 (reliability). It has a child-friendly design, is easy accessible online and gives immediate feedback reports of scores. CONCLUSIONS The Kids-CAT has the potential to advance pediatric HRQoL measurement by making it less burdensome and enhancing the patient-doctor communication.
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Kolobe THA, Christy JB, Gannotti ME, Heathcock JC, Damiano DL, Taub E, Majsak MJ, Gordon AM, Fuchs RK, O'Neil ME, Caiozzo VJ. Research summit III proceedings on dosing in children with an injured brain or cerebral palsy: executive summary. Phys Ther 2014; 94:907-20. [PMID: 24525862 PMCID: PMC4078265 DOI: 10.2522/ptj.20130024] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2013] [Accepted: 02/10/2014] [Indexed: 11/17/2022]
Affiliation(s)
- Thubi H A Kolobe
- T.H.A. Kolobe, PT, PhD, FAPTA, Department of Rehabilitation Science, University of Oklahoma Health Sciences Center, 801 NE 13th St, Oklahoma City, OK 73104 (USA).
| | - Jennifer Braswell Christy
- J.B. Christy, PT, PhD, Department of Physical Therapy, University of Alabama at Birmingham, Birmingham, Alabama
| | - Mary E Gannotti
- M.E. Gannotti, PT, PhD, Department of Rehabilitation Sciences, University of Hartford, West Hartford, Connecticut
| | - Jill C Heathcock
- J.C. Heathcock, PT, PhD, Division of Physical Therapy, Ohio State University Medical Center, Columbus, Ohio
| | - Diane L Damiano
- D.L. Damiano, PT, PhD, Rehabilitation Medicine Department, National Institutes of Health, Bethesda, Maryland
| | - Edward Taub
- E. Taub, PhD, Department of Psychology, University of Alabama at Birmingham
| | - Michael J Majsak
- M.J. Majsak, PT, EdD, Program in Physical Therapy, School of Public Health, New York Medical College, Valhalla, New York
| | - Andrew M Gordon
- A.M. Gordon, PhD, Department of Biobehavioral Sciences, Columbia University, New York, New York
| | - Robyn K Fuchs
- R.K. Fuchs, PhD, Department of Physical Therapy, School of Health and Rehabilitation Sciences, Indiana University, Indianapolis, Indiana
| | - Margaret E O'Neil
- M.E. O'Neil, PT, PhD, MPH, Department of Physical Therapy and Rehabilitation Sciences, Drexel University, Philadelphia, Pennsylvania
| | - Vincent J Caiozzo
- V.J. Caiozzo, PhD, Department of Orthopedics and Physiology & Biophysics, School of Medicine, University of California-Irvine, Irvine, California
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Gannotti ME, Christy JB, Heathcock JC, Kolobe THA. A path model for evaluating dosing parameters for children with cerebral palsy. Phys Ther 2014; 94:411-21. [PMID: 24231231 PMCID: PMC3967121 DOI: 10.2522/ptj.20130022] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2013] [Accepted: 11/08/2013] [Indexed: 11/17/2022]
Abstract
Dosing of pediatric rehabilitation services for children with cerebral palsy (CP) has been identified as a national priority. Establishing dosing parameters for pediatric physical therapy interventions is critical for informing clinical decision making, health policy, and guidelines for reimbursement. The purpose of this perspective article is to describe a path model for evaluating dosing parameters of interventions for children with CP. The model is intended for dose-related and effectiveness studies of pediatric physical therapy interventions. The premise of the model is: Intervention type (focus on body structures, activity, or the environment) acts on a child first through the family, then through the dose (frequency, intensity, time), to yield structural and behavioral changes. As a result, these changes are linked to improvements in functional independence. Community factors affect dose as well as functional independence (performance and capacity), influencing the relationships between type of intervention and intervention responses. The constructs of family characteristics; child characteristics (eg, age, level of severity, comorbidities, readiness to change, preferences); plastic changes in bone, muscle, and brain; motor skill acquisition; and community access warrant consideration from researchers who are designing intervention studies. Multiple knowledge gaps are identified, and a framework is provided for conceptualizing dosing parameters for children with CP.
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Affiliation(s)
- Mary E Gannotti
- M.E. Gannotti, PT, PhD, Department of Rehabilitation Sciences, University of Hartford, 200 Bloomfield Ave, West Hartford, CT 06117 (USA)
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Kratz AL, Slavin MD, Mulcahey MJ, Jette AM, Tulsky DS, Haley SM. An examination of the PROMIS(®) pediatric instruments to assess mobility in children with cerebral palsy. Qual Life Res 2013; 22:2865-76. [PMID: 23543391 PMCID: PMC3758380 DOI: 10.1007/s11136-013-0397-6] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2013] [Indexed: 12/31/2022]
Abstract
PURPOSE The Patient-Reported Outcomes Measurement Information System (PROMIS(®)) provides adult and pediatric self-report measures of health-related quality of life designed for use across medical conditions and the general population. The purpose of this study was to examine the feasibility and validity of the PROMIS(®) Pediatric Short Form and computer-adaptive test (CAT) mobility measures in children with cerebral palsy (CP). METHODS Eighty-two children with CP completed self-report (PROMIS(®) Mobility Short Form, PROMIS(®) Mobility CAT, Pediatric Quality of Life Inventory™) and performance-based assessments of mobility (Timed Up and Go, Gross Motor Function Measure). Parents provided three proxy reports of child mobility (Pediatric Outcomes Data Collection Instrument, Functional Assessment Questionnaire, Shriners Hospitals for Children CP-CAT). Validity of PROMIS(®) instruments was examined through correlations with other measures and "known groups" analyses determined by Gross Motor Function Classification System (GMFCS). RESULTS On average, the PROMIS(®) CAT required less than seven items and 2 minutes to administer. Both PROMIS(®) measures showed moderate to high correlations with child- and parent-proxy report of child mobility; correlations with performance-based measure were small for the PROMIS(®) Short Form and non-significant for the PROMIS(®) CAT. All measures except for the PROMIS(®) CAT were able to distinguish between GMFCS categories. CONCLUSIONS Results support the convergent and discriminant validity of the pediatric PROMIS(®) Mobility Short Form in children with CP. The PROMIS(®) Mobility CAT correlates well with child report and parent report of mobility but not with performance-based measures and does not differentiate between known mobility groups.
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Affiliation(s)
- Anna L Kratz
- Department of Physical Medicine and Rehabilitation, University of Michigan, 325 E. Eisenhower Parkway, Suite 300, Ann Arbor, MI, USA,
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Mulcahey MJ, Merenda L, Tian F, Kozin S, James M, Gogola G, Ni P. Computer Adaptive Test Approach to the Assessment of Children and Youth With Brachial Plexus Birth Palsy. Am J Occup Ther 2013; 67:524-33. [DOI: 10.5014/ajot.2013.008037] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Abstract
This study examined the psychometric properties of item pools relevant to upper-extremity function and activity performance and evaluated simulated 5-, 10-, and 15-item computer adaptive tests (CATs). In a multicenter, cross-sectional study of 200 children and youth with brachial plexus birth palsy (BPBP), parents responded to upper-extremity (n = 52) and activity (n = 34) items using a 5-point response scale. We used confirmatory and exploratory factor analysis, ordinal logistic regression, item maps, and standard errors to evaluate the psychometric properties of the item banks. Validity was evaluated using analysis of variance and Pearson correlation coefficients. Results show that the two item pools have acceptable model fit, scaled well for children and youth with BPBP, and had good validity, content range, and precision. Simulated CATs performed comparably to the full item banks, suggesting that a reduced number of items provide similar information to the entire set of items.
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Affiliation(s)
- M. J. Mulcahey
- M. J. Mulcahey, PhD, OTR/L, is Professor of Occupational Therapy, Thomas Jefferson University, School of Health Professions, 901 Walnut Street, 6th Floor, Philadelphia, PA 19107, and Scientific Staff, Shriners Hospitals for Children, Philadelphia;
| | - Lisa Merenda
- Lisa Merenda, MSN, is Research Nurse, Shriners Hospitals for Children, Philadelphia
| | - Feng Tian
- Feng Tian, PhD, is Associate Professor, Health and Disability Research Institute, School of Public Health, Boston University, Boston
| | - Scott Kozin
- Scott Kozin, MD, is Chief of Staff, Shriners Hospitals for Children, Philadelphia
| | - Michelle James
- Michelle James, MD, is Chief of Orthopedics, Shriners Hospitals for Children Northern California, Sacramento
| | - Gloria Gogola
- Gloria Gogola, MD, is Medical Staff, Shriners Hospitals for Children, Houston
| | - Pengsheng Ni
- Pengsheng Ni, MD, PhD, is Associate Professor, Health and Disability Research Institute, School of Public Health, Boston University, Boston
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Bent LM, Mulcahey MJ, Kelly EH, Calhoun CL, Tian F, Ni P, Vogel LC, Haley SM. Validity of computer adaptive tests of daily routines for youth with spinal cord injury. Top Spinal Cord Inj Rehabil 2013; 19:104-13. [PMID: 23671380 DOI: 10.1310/sci1902-104] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To evaluate the accuracy of computer adaptive tests (CATs) of daily routines for child- and parent-reported outcomes following pediatric spinal cord injury (SCI) and to evaluate the validity of the scales. METHODS One hundred ninety-six daily routine items were administered to 381 youths and 322 parents. Pearson correlations, intraclass correlation coefficients (ICC), and 95% confidence intervals (CI) were calculated to evaluate the accuracy of simulated 5-item, 10-item, and 15-item CATs against the full-item banks and to evaluate concurrent validity. Independent samples t tests and analysis of variance were used to evaluate the ability of the daily routine scales to discriminate between children with tetraplegia and paraplegia and among 5 motor groups. RESULTS ICC and 95% CI demonstrated that simulated 5-, 10-, and 15-item CATs accurately represented the full-item banks for both child- and parent-report scales. The daily routine scales demonstrated discriminative validity, except between 2 motor groups of children with paraplegia. Concurrent validity of the daily routine scales was demonstrated through significant relationships with the FIM scores. CONCLUSION Child- and parent-reported outcomes of daily routines can be obtained using CATs with the same relative precision of a full-item bank. Five-item, 10-item, and 15-item CATs have discriminative and concurrent validity.
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Affiliation(s)
- Leah M Bent
- Shriners Hospitals for Children-Chicago , Chicago, Illinois
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Evaluation of the box and blocks test, stereognosis and item banks of activity and upper extremity function in youths with brachial plexus birth palsy. J Pediatr Orthop 2012; 32 Suppl 2:S114-22. [PMID: 22890449 DOI: 10.1097/bpo.0b013e3182595423] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND One of the greatest limitations to measuring outcomes in pediatric orthopaedics is the lack of effective instruments. Computer adaptive testing, which uses large item banks, select only items that are relevant to a child's function based on a previous response and filters items that are too easy or too hard or simply not relevant to the child. In this way, computer adaptive testing provides for a meaningful, efficient, and precise method to evaluate patient-reported outcomes. Banks of items that assess activity and upper extremity (UE) function have been developed for children with cerebral palsy and have enabled computer adaptive tests that showed strong reliability, strong validity, and broader content range when compared with traditional instruments. Because of the void in instruments for children with brachial plexus birth palsy (BPBP) and the importance of having an UE and activity scale, we were interested in how well these items worked in this population. METHODS Cross-sectional, multicenter study involving 200 children with BPBP was conducted. The box and block test (BBT) and Stereognosis tests were administered and patient reports of UE function and activity were obtained with the cerebral palsy item banks. Differential item functioning (DIF) was examined. Predictive ability of the BBT and stereognosis was evaluated with proportional odds logistic regression model. Spearman correlations coefficients (rs) were calculated to examine correlation between stereognosis and the BBT and between individual stereognosis items and the total stereognosis score. RESULTS Six of the 86 items showed DIF, indicating that the activity and UE item banks may be useful for computer adaptive tests for children with BPBP. The penny and the button were strongest predictors of impairment level (odds ratio=0.34 to 0.40]. There was a good positive relationship between total stereognosis and BBT scores (rs=0.60). The BBT had a good negative (rs=-0.55) and good positive (rs=0.55) relationship with the clinical category of BPBP and Raimondi classification, respectively. There was a moderate negative (rs=-0.36) and moderate positive (rs=0.47) relationship between total stereognosis and clinical category of BPBP and Raimondi, respectively. Individual stereognosis items had moderate (rs=0.34 to 0.45) to good (rs=0.52 to 0.74) correlation with total stereognosis score. CONCLUSIONS In children with BPBP, there was little to no DIF with item banks of activity and UE functioning. The BBT is a good predictor of degree of impairment. Stereognosis with 2 items may provide comparable information as 12 items. LEVELS OF EVIDENCE Level II.
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Haley SM, Coster WJ, Dumas HM, Fragala-Pinkham MA, Kramer J, Ni P, Tian F, Kao YC, Moed R, Ludlow LH. Accuracy and precision of the Pediatric Evaluation of Disability Inventory computer-adaptive tests (PEDI-CAT). Dev Med Child Neurol 2011; 53:1100-6. [PMID: 22077695 PMCID: PMC3638866 DOI: 10.1111/j.1469-8749.2011.04107.x] [Citation(s) in RCA: 122] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM The aims of the study were to: (1) build new item banks for a revised version of the Pediatric Evaluation of Disability Inventory (PEDI) with four content domains: daily activities, mobility, social/cognitive, and responsibility; and (2) use post-hoc simulations based on the combined normative and disability calibration samples to assess the accuracy and precision of the PEDI computer-adaptive tests (PEDI-CAT) compared with the administration of all items. METHOD Parents of typically developing children (n = 2205) and parents of children and adolescents with disabilities (n = 703) between the ages of 0 and 21 years, stratified by age and sex, participated by responding to PEDI-CAT surveys through an existing Internet opt-in survey panel in the USA and by computer tablets in clinical sites. RESULTS Confirmatory factor analyses supported four unidimensional content domains. Scores using the real data post hoc demonstrated excellent accuracy (intraclass correlation coefficients ≥ 0.95) with the full item banks. Simulations using item parameter estimates demonstrated relatively small bias in the 10-item and 15-item CAT versions; error was generally higher at the scale extremes. INTERPRETATION These results suggest the PEDI-CAT can be an accurate and precise assessment of children's daily performance at all functional levels.
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Affiliation(s)
- Stephen M. Haley
- Health & Disability Research Inst., School of Public Health, Boston University, Boston, MA, USA
| | - Wendy J. Coster
- Department of Occupational Therapy, Sargent College of Health & Rehabilitation Sciences, Boston University, Boston, MA, USA
| | - Helene M. Dumas
- Research Center for Children with Special Health Care Needs, Franciscan Hospital for Children, Boston, MA, USA
| | - Maria A. Fragala-Pinkham
- Research Center for Children with Special Health Care Needs, Franciscan Hospital for Children, Boston, MA, USA
| | - Jessica Kramer
- Occupational Therapy, Boston University Sargent College of Health & Rehabilitation Sciences
| | - Pengsheng Ni
- Health & Disability Research Inst., Boston University School of Public Health
| | - Feng Tian
- Health & Disability Research Inst., Boston University School of Public Health
| | - Ying-Chia Kao
- Department of Occupational Therapy, Boston University Sargent College of Health & Rehabilitation Sciences
| | | | - Larry H. Ludlow
- Department of Educational Research, Measurement and Evaluation, Boston College Lynch School of Education, Chestnut Hill, MA, USA
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Dumas HM, Fragala-Pinkham MA, Haley SM, Ni P, Coster W, Kramer JM, Kao YC, Moed R, Ludlow LH. Computer adaptive test performance in children with and without disabilities: prospective field study of the PEDI-CAT. Disabil Rehabil 2011; 34:393-401. [PMID: 21988750 DOI: 10.3109/09638288.2011.607217] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To examine the discriminant validity, test-retest reliability, administration time and acceptability of the pediatric evaluation of disability inventory computer adaptive test (PEDI-CAT). METHODS A sample of 102 parents of children 3 through 20 years of age with (n = 50) and without (n = 52) disabilities was recruited for this prospective field study. A sub-sample (n = 25) also completed the PEDI-CAT a second time within one month. Parents completed 15 items in each of the four PEDI-CAT domains (daily activities, mobility, social/cognitive, responsibility) using a laptop computer. Following completion, parents answered a four-question user evaluation survey. RESULTS PEDI-CAT scores based on parent responses differentiated between groups of children with and without disabilities in all four domains. Test-retest reliability estimates were high (ICC = 0.96-0.99) for all four domains. The mean time to complete 60 items for the full sample (n = 102) was 12.66 minutes (SD = 4.47). Parents reported favorable reactions to the PEDI-CAT. CONCLUSIONS The PEDI-CAT offers a valid and reliable assessment acceptable to parents.
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Affiliation(s)
- Helene M Dumas
- Research Center, Franciscan Hospital for Children, Boston, MA 02135, USA.
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