|Harvey, A., Robin, J., Morris, M. E., Graham, H. K., & Baker, R. (2008). A systematic review of measures of activity limitation for children with cerebral palsy. Developmental Medicine & Child Neurology 50, 190-198.
|Background: Systematic reviews concerned with outcome measures in cerebral palsy (CP) have generally focused on quality of life measures, child or family assessed activity and participation measures, or participation measures. A small number reviews are available on activity-based physical function scales; however, these are narrative reviews, lacking contemporary search strategies or critical evaluation procedures.
Objectives: To conduct a systematic review of the literature on the psychometric properties and clinical utility of the evaluative measures of activity for children with CP.
Search Strategy: Studies were found by conducting a search of electronic databases (MEDLINE, EMBASE, CINAHL, and PsychINFO) and through targeted hand searches utilizing reference lists form key articles searching relevant journals. Keywords used were: cerebral palsy, psychometrics, reliability, validity, and responsiveness. More in depth strategies were employed where appropriate.
Selection Criteria: Tools were included if they were developed for children aged 0-18 years with CP, or developmental disabilities and neurological conditions that include CP; if they were evaluative tools that measured activity or activity limitation with emphasis on mobility and gross motor function; and were clinically-based judgments or scales. Peer reviewed investigations that assessed included tools and that tested the psychometric properties of the tool with a sample of children with CP were also included.
Data Collection and Analysis: An original quality assessment checklist was created to evaluate the types of studies included in this review. Quality assessment items were matched to corresponding thematic items of data extraction on a combined form. Two reviewers independently reviewed the articles. In cases of disagreement, consensus was reached through discussion with a third author.
Main Results: Twenty-nine articles met inclusion requirements; in these 29, eight different evaluative tools were reported. The authors reported on study design, feasibility and clinical utility of tools, and results of psychometric testing.
Conclusions: In general the reliability of most tools was found to be adequate, with the exception of two tools. Further examination of validity is required. Also, to assess children with CP effectively, a range of tools is required, some of which are better suited for clinical use and others of which are better suited for research use. Selection of tools should be tailored to the clinical setting, children involved, and purpose of measurement.