A systematic review of measures of activity limitation for children with cerebral palsy

Abstract

This systematic review critically appraises the literature on the psychometric properties and clinical utility of evaluative activity limitation outcome measures used for children with cerebral palsy (CP). The search strategy yielded 29 articles for eight outcome measures that met the inclusion criteria for the review. The Gross Motor Function Measure and Activities Scale for Kids were found to have sound psychometric properties in most areas. Reliability was found to be adequate for all tools. For the CP population, further examination of some aspects of validity is required for the Child Health Questionnaire (CHQ), Functional Assessment Questionnaire (FAQ), Functional Mobility Scale (FMS), Pediatric Evaluation of Disability Inventory, Pediatric Outcomes Data Collection Instrument (PODCI), and the Functional Independence Measure for Children. The FAQ, CHQ, FMS, and PODCI were found to require further examination for responsiveness. Clinical utility of the measures varied. The FMS was the only one to differentiate between function in the home, school, and community and to consider different assistive devices. These findings suggest that a range of measures is required to evaluate activity, and assessment should be tailored to the individual needs of children with CP.

Assessment Tools and Classification Systems Used For the Upper Extremity in Children With Cerebral Palsy

“…Although the 21 tools selected for inclusion in the review were all commonly used in the literature, there may have been a possible tool selection bias based on the authors and queried experts professional backgrounds and clinical experiences. Perhaps the area of greatest challenge to investigators is related to instrument responsiveness [19,55]. There is little in the existing literature that addresses the fundamental issue of what change in the score of a test after an intervention is clinically important.…”

“…The Activities Scale for Kids (ASK) is a child self-report measure of physical performance [19,41]. The ASK was originally designed for children between 5 and 15 years of age with musculoskeletal disorders but without major cognitive impairment.…”

“…The Child Health Questionnaire (CHQ) is a questionnaire that attempts to describe multiple aspects of health-related quality of life as it relates to the physical and psychosocial functioning of children [19,41]. The CHQ was designed for children between 5 and 18 years of age regardless of their diagnoses.…”

“…The Functional Independence Measure (FIM) and the Functional Independence Measure for Children (WeeFIM) are functional and/or perception of performance measures that may be clinician-or caregiver-based [19,25]. The FIM is for adult populations.…”

“…The Pediatric Evaluation of Disability Inventory (PEDI) is a functional and/or perception of performance assessment tool that may be completed by a caregiver or professional provider [19,25]. The PEDI is best completed through a structured interview but can be completed through professional observation.…”