Petra Marsico - Academia.edu (original) (raw)
Papers by Petra Marsico
Selective Control Assessment of the Lower Extremity--German Version
PsycTESTS Dataset, 2016
What are the relevant categories, modalities, and outcome measures for assessing lower limb somatosensory function in children with upper motor neuron lesions? A Delphi study
Disability and Rehabilitation
Hypertonia assessment tool: reliability and validity in children with neuromotor disorders
Neuroorthopädie - Disability Management, 2021
Developmental Neurorehabilitation, 2021
Purpose: A systematic review of the psychometric properties and feasibility of outcome measures a... more Purpose: A systematic review of the psychometric properties and feasibility of outcome measures assessing lower limb somatosensory function and body awareness in children with upper motor neuron lesion. Methods: We followed the COnsensus-based Standards for the selection of health Measurement INstruments guidelines. Two raters independently judged the quality and risk of bias of each study. Data synthesis was performed, and aspects of feasibility were extracted. Results: Twelve studies investigated eleven somatosensory function measures quantifying four modalities and eight body awareness measures quantifying two modalities. The best evidence synthesis was very low to low for somatosensory function modalities and low for body awareness modalities. Few feasibility aspects were reported (e.g., the percentage or minimum age of participants able to perform the tests). Conclusion: Current evidence on the psychometric characteristics of somatosensory function and body awareness outcome measures are relatively sparse. Further research on psychometric properties and practical application is needed.
Ausbildung für Therapieberufe
Eine fundierte Aus- und Weiterbildung ist fur samtliche Berufsgruppen, die auf dem Gebiet der Neu... more Eine fundierte Aus- und Weiterbildung ist fur samtliche Berufsgruppen, die auf dem Gebiet der Neuroorthopadie arbeiten, von groser Bedeutung. Die Beschaftigung mit Kindern, deren Familien und Erwachsenen mit seltenen Erkrankungen und verschiedenen Behinderungsgraden stellt gerade fur Berufsanfanger eine Herausforderung dar. In der Regel werden die spezifischen Kenntnisse und Fahigkeiten in der Grundausbildung nicht angeboten. Damit fur die tagliche Zusammenarbeit in Klinik und Praxis eine gemeinsame Sprache des Behandlungsteams gesprochen werden kann, muss die Weiterbildung interdisziplinar erfolgen. Neben spezialisierten Ausbildungsprogrammen fur die einzelnen Berufsgruppen hat sich in den letzten Jahrzehnten ein breites Weiterbildungsangebot entwickelt, das von allen Interessierten besucht werden kann.
Velocity dependent measure of spasticity: Reliability in children and juveniles with neuromotor disorders
Journal of Pediatric Rehabilitation Medicine, 2021
PURPOSE: The purpose of this study was to create a clear, standardized test description to rate s... more PURPOSE: The purpose of this study was to create a clear, standardized test description to rate spasticity severity into four categories according to the definition given by Lance [1], referred to as the Velocity Dependent Measure of Spasticity (VDMS). METHOD: Muscle groups of the upper and lower limbs of children with neuromotor disorders were evaluated on their response to passive movement in a fast-versus slow-velocity test condition. The interrater and test-retest reliability were assessed using Gwet’s alpha one (95%-CI) and the percentage agreement. RESULTS: Two physiotherapists independently assessed 45 children and youths (age 4–19 years). The interrater reliability of the VDMS was substantial to almost perfect (Gwet’s alpha one: 0.66–0.99, n= 45) while the test-retest reliability was almost perfect as well (Gwet’s alpha one: 0.83–1.00, n= 42). CONCLUSION: The VDMS can be recommended as a reliable assessment with a standardized procedure to assess spasticity of the extremitie...
Advances in Neurodevelopmental Disorders, 2021
Objectives The techniques facilitation of activities, arrangement of task or situation, verbal an... more Objectives The techniques facilitation of activities, arrangement of task or situation, verbal and non-verbal communication, and counseling and empowerment of parents and caregivers are applied in different therapy approaches to improve motor function in children with neuromotor disorders. This review quantitatively examines the effectiveness of these four techniques allocated to pre-defined age groups and levels of disability. Methods We followed the systematic review methodology proposed by the American Academy for Cerebral Palsy and Developmental Medicine (AACPDM). The search was conducted on PubMed, Scopus, EMBASE, PEDro, OT Seeker, ERIC, and CINAHL. The main outcomes of the included articles were allocated to the framework of the International Classification of Functioning, Disability, and Health (body functions, activities, and participation). Results The search yielded eleven studies for facilitation, 22 for arrangement of task or situation, three for verbal and non-verbal co...
Therapie zur Verbesserung alltagsrelevanter Transfers
Therapeutisches Arbeiten in der Neuroorthopädie, 2021
Interventionen früh beginnen – Mobilität von Kindern mit Zerebralparese
physiopraxis, 2021
Die Zerebralparese ist die häufigste Ursache für körperliche Behinderungen im frühen Kindesalter.... more Die Zerebralparese ist die häufigste Ursache für körperliche Behinderungen im frühen Kindesalter. Sie begleitet die betroffenen Menschen für den Rest ihres Lebens. In diesem Überblick erfahren Sie, wie sich die Mobilität bei Zerebralparese entwickeln kann und wie wichtig es ist, dass auch Kinder schon frühzeitig ihr größtmögliches Potenzial ausschöpfen.
Hypertonia Assessment Tool--German Version
PsycTESTS Dataset, 2014
Developmental Medicine & Child Neurology, 2018
AIM: As there is little evidence for concurrent validity of the Eating and Drinking Ability Class... more AIM: As there is little evidence for concurrent validity of the Eating and Drinking Ability Classification System (EDACS), this study aimed to determine its concurrent validity and reliability in children and adolescents with cerebral palsy (CP). METHOD: After an extensive translation procedure, we applied the German language version to 52 participants with CP (30 males, 22 females, mean age 9y 7mo [SD 4y 2mo]). We correlated (Kendall's tau or K) the EDACS levels with the Bogenhausener Dysphagiescore (BODS), and the EDACS level of assistance with the Manual Ability Classification System (MACS) and the item 'eating' of the Functional Independence Measure for Children (WeeFIM). We further quantified the interrater reliability between speech and language therapists (SaLTs) and between SaLTs and parents with Kappa (). RESULTS: The EDACS levels correlated highly with the BODS (K =0.79), and the EDACS level of assistance correlated highly with the MACS (K =0.73) and WeeFIM eating item (K =-0.80). Interrater reliability proved almost perfect between SaLTs (EDACS: =0.94; EDACS level of assistance: =0.89) and SaLTs and parents (EDACS: =0.82; EDACS level of assistance: =0.89). INTERPRETATION: The EDACS levels and level of assistance seem valid and showed almost perfect interrater reliability when classifying eating and drinking problems in children and adolescents with CP. WHAT THIS PAPER ADDS: The Eating and Drinking Ability Classification System (EDACS) correlates well with a dysphagia score. The EDACS level of assistance proves valid. The German version of EDACS is highly reliable. EDACS correlates moderately to highly with other classification systems.
Disability and Rehabilitation, 2017
PURPOSE: We investigated the combined impact of trunk control and lower extremities impairments o... more PURPOSE: We investigated the combined impact of trunk control and lower extremities impairments on predicting gait capacity in children with cerebral palsy (CP) and evaluated relationships between trunk control and lower extremities impairments. METHODS: Data of 52 children with CP [29 boys, mean age 11 years 9 months (±4 years 6 months)] were included in this observational study. Gait capacity was measured by the "modified Time Up and Go test". Experienced therapists performed the "Modified Ashworth Scale", "Manual Muscle Test", the "Selective Control Assessment of the Lower Extremity", and the "Trunk Control Measurement Scale". We calculated Spearman correlations coefficients () and performed regression analyses. RESULTS: Trunk control was the strongest predictor ( = -0.624, p < 0.001) when explaining the variance of gait capacity and remained in the model together with spasticity (R2 = 0.67). Muscle strength and selectivity correlated moderately to strongly with the trunk control and gait capacity (-0.68 -0.78), but correlations for the spasticity were low (<-0.3). CONCLUSIONS: The interconnection between trunk control, leg muscle strength and selectivity for gait capacity in children with CP was shown. It indicates the significance of these impairments in gait assessment and, potentially, rehabilitation. Implications for Rehabilitation Trunk control was the strongest predictor for gait capacity in a regression model with lower extremity spasticity, muscle strength and selectivity and age as independent variables. Lower extremity muscle strength, selectivity, and trunk control explained a similar amount of gait capacity variance which is higher than that explained by lower extremity spasticity. Lower extremity muscle strength and selectivity correlated strongly with trunk control. Therefore, we cautiously suggest that a combined trunk control and lower extremity training might be promising for improving gait capacity in children with CP (Gross Motor Function Classification System level I-III), which needed to be tested in future intervention-studies.
Developmental Medicine & Child Neurology, 2017
This study investigated the intra-and interrater reliability of the Trunk Control Measurement Sca... more This study investigated the intra-and interrater reliability of the Trunk Control Measurement Scale (TCMS) German version, with its subscores, in children with neuromotor disorders. Further, the discriminative validity of the TCMS was assessed by comparing the TCMS scores with the Functional Independence Measure for children. METHOD: Bland-Altman analyses and intraclass correlation coefficients were applied to investigate reliability. The discriminative ability of the TCMS was evaluated with receiver operating characteristics. RESULTS: Ninety children (mean age 11y 5mo; range 5y-18y 11mo) participated for the reliability, and 50 for the discriminative validity study. The reliability proved to be excellent (intrarater: bias=0.57 points, 95% confidence interval [CI] -3.71 to 4.85; interrater: bias=-0.31 points, 95% CI -5.77 to 5.10). A change in the TCMS total score of six points (10%) can be considered a true change. The TCMS subscores appeared to be clinically relevant because children with less than around 80% of the static balance score, less than 55% of the dynamic reaching score, or less than around 35% of the selective movement control score needed support for daily life activities. INTERPRETA-TION: The TCMS is a reliable and clinically relevant assessment for children aged 5 years and older with different neurological impairments.
Hypertonia Assessment Tool
Journal of Child Neurology, 2016
The Hypertonia Assessment Tool is a 7-item instrument that discriminates spasticity, dystonia, an... more The Hypertonia Assessment Tool is a 7-item instrument that discriminates spasticity, dystonia, and rigidity on 3 levels: item scores, subtype, and hypertonia diagnosis for each extremity. We quantified the inter- and intrarater reliability using Kappa statistics, Gwet’s first-order agreement coefficient (both with 95% confidence interval), and percentage agreement for all levels. For validity, we compared the Hypertonia Assessment Tool subtype with the clinical diagnosis provided by the physicians. Two physiotherapists tested 45 children with neuromotor disorders. The interrater reliability (n = 45) of the Hypertonia Assessment Tool subtype was moderate to substantial whereas the intrarater reliability (n = 42) was almost perfect. The Hypertonia Assessment Tool showed good agreement in detecting spasticity. On the contrary, there was a higher presence of dystonia of 24% to 25% tested with the Hypertonia Assessment Tool compared to the clinical diagnosis. Even some individual items s...
European Journal of Paediatric Neurology, 2015
In this paper, we give some applications of a Newtontype method for constrained nonsmooth equatio... more In this paper, we give some applications of a Newtontype method for constrained nonsmooth equations. The method is proposed by F.Facchinei and etc, which use linear programming model for the solution of constrained nonsmooth equations. The applications of the method including in solving constrained maximum equations and generalized complementarity problems.
Research in Developmental Disabilities, 2015
Childhood cerebral palsy and the use of positioning systems to control body posture: Current prac... more Childhood cerebral palsy and the use of positioning systems to control body posture: Current practices.
Construct validity and reliability of the Selective Control Assessment of the Lower Extremity in children with cerebral palsy
Developmental Medicine & Child Neurology, 2015
Assessing impaired selective voluntary movement control in children with cerebral palsy (CP) has ... more Assessing impaired selective voluntary movement control in children with cerebral palsy (CP) has gained increasing interest. We investigated construct validity and intra- and interrater reliability of the Selective Control Assessment of the Lower Extremity (SCALE). Thirty-nine children (21 males, 18 females) with spastic CP, mean age 12 years 6 months [range 6y 11mo-19y 9mo], Gross Motor Function Classification System (GMFCS) levels I to IV, participated. Differences in SCALE scores were determined on joint levels and between patients categorized according to their limb distribution and GMFCS levels. SCALE scores were correlated with the Fugl-Meyer Assessment, Manual Muscle Test, and Modified Ashworth Scale. To determine reliability, the SCALE was applied once and recorded on video. SCALE scores differed significantly between the less and more affected leg (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001) and between most leg joints. Total SCALE scores differed significantly between GMFCS levels I and II. Correlations with Fugl-Meyer Assessment, Manual Muscle Test, and Modified Ashworth Scale were 0.88, 0.88, and -0.55 respectively. Intraclass correlation coefficients were all above 0.9, with the minimal detectable change below 2 points. The SCALE appears to be a valid and reliable tool to assess selective voluntary movement control of the legs in children with spastic CP.
Reliability and practicability of the straight leg raise test in children with cerebral palsy
Developmental Medicine & Child Neurology, 2015
Preventing restrictions to lower limb movement is part of the treatment given to children with ce... more Preventing restrictions to lower limb movement is part of the treatment given to children with cerebral palsy (CP). Such restrictions can be assessed using the &amp;amp;amp;#39;straight leg raise&amp;amp;amp;#39; (SLR) test. This study investigated the interrater reliability and practicability of the SLR test in children with CP. Experienced physiotherapists examined 23 children with CP (6-18y; eight females, 15 males) twice. The SLR hip range of motion (ROM) was measured using an electrogoniometer, and the test was rated based on sensitizing manoeuvres and biceps femoris muscle activity. Practicability was investigated by evaluating children&amp;amp;amp;#39;s subjective feedback on the tolerable ROM. Intraclass correlation coefficients for the SLR hip ROM varied, ranging from 0.84 (95% CI 0.61-0.93) to 0.93 (95% CI 0.87-0.96). Physiotherapists substantially agreed on SLR ratings (Cohen&amp;amp;amp;#39;s kappa=0.73). Biceps femoris muscle activity decreased significantly with the release of tension on the sciatic nerve. All children were able to communicate the location and sensation of the maximally tolerated position. The SLR test proved to be reliable and practicable in children with CP and might improve clinical reasoning processes. Lower limb movement restrictions in these children may partly be related to limitations in sciatic nerve mobility. Further studies should investigate if the SLR test could estimate activities in children with CP.
BMC Neurology
Background: In children with cerebral palsy (CP), stiffness, caused by contractile and non-contra... more Background: In children with cerebral palsy (CP), stiffness, caused by contractile and non-contractile structures, can influence motor performance. This study sought to determine whether the nerve mobility had a relevant impact on motor performance in children with CP. We hypothesized that a positive Straight Leg Raise (SLR) test, as well as smaller SLR hip angle, would relate to lower leg muscle strength, reduced motor capacity and less motor performance in children with CP. Methods: We applied a cross-sectional analysis on data including SLR, leg muscle strength, Gross Motor Function Measure (GMFM-66) and number of activity counts during daily life from thirty children with CP (6-18 years). We performed receiver operating characteristics and correlation analyses. Results: Positive SLR test could distinguish well between children with low versus high muscle strength and GMFM-66 scores. The SLR hip angle correlated significant with the level of disability and with muscle strength. The correlation with the GMFM-66 and the activity counts was fair. Conclusion: This study suggests that neural restriction of SLR is higher on functional and activity outcome than the measured SLR hip range of motion. Further studies should investigate weather improving nerve mobility can lead to an amelioration of function in children with CP.
Selective Control Assessment of the Lower Extremity--German Version
PsycTESTS Dataset, 2016
What are the relevant categories, modalities, and outcome measures for assessing lower limb somatosensory function in children with upper motor neuron lesions? A Delphi study
Disability and Rehabilitation
Hypertonia assessment tool: reliability and validity in children with neuromotor disorders
Neuroorthopädie - Disability Management, 2021
Developmental Neurorehabilitation, 2021
Purpose: A systematic review of the psychometric properties and feasibility of outcome measures a... more Purpose: A systematic review of the psychometric properties and feasibility of outcome measures assessing lower limb somatosensory function and body awareness in children with upper motor neuron lesion. Methods: We followed the COnsensus-based Standards for the selection of health Measurement INstruments guidelines. Two raters independently judged the quality and risk of bias of each study. Data synthesis was performed, and aspects of feasibility were extracted. Results: Twelve studies investigated eleven somatosensory function measures quantifying four modalities and eight body awareness measures quantifying two modalities. The best evidence synthesis was very low to low for somatosensory function modalities and low for body awareness modalities. Few feasibility aspects were reported (e.g., the percentage or minimum age of participants able to perform the tests). Conclusion: Current evidence on the psychometric characteristics of somatosensory function and body awareness outcome measures are relatively sparse. Further research on psychometric properties and practical application is needed.
Ausbildung für Therapieberufe
Eine fundierte Aus- und Weiterbildung ist fur samtliche Berufsgruppen, die auf dem Gebiet der Neu... more Eine fundierte Aus- und Weiterbildung ist fur samtliche Berufsgruppen, die auf dem Gebiet der Neuroorthopadie arbeiten, von groser Bedeutung. Die Beschaftigung mit Kindern, deren Familien und Erwachsenen mit seltenen Erkrankungen und verschiedenen Behinderungsgraden stellt gerade fur Berufsanfanger eine Herausforderung dar. In der Regel werden die spezifischen Kenntnisse und Fahigkeiten in der Grundausbildung nicht angeboten. Damit fur die tagliche Zusammenarbeit in Klinik und Praxis eine gemeinsame Sprache des Behandlungsteams gesprochen werden kann, muss die Weiterbildung interdisziplinar erfolgen. Neben spezialisierten Ausbildungsprogrammen fur die einzelnen Berufsgruppen hat sich in den letzten Jahrzehnten ein breites Weiterbildungsangebot entwickelt, das von allen Interessierten besucht werden kann.
Velocity dependent measure of spasticity: Reliability in children and juveniles with neuromotor disorders
Journal of Pediatric Rehabilitation Medicine, 2021
PURPOSE: The purpose of this study was to create a clear, standardized test description to rate s... more PURPOSE: The purpose of this study was to create a clear, standardized test description to rate spasticity severity into four categories according to the definition given by Lance [1], referred to as the Velocity Dependent Measure of Spasticity (VDMS). METHOD: Muscle groups of the upper and lower limbs of children with neuromotor disorders were evaluated on their response to passive movement in a fast-versus slow-velocity test condition. The interrater and test-retest reliability were assessed using Gwet’s alpha one (95%-CI) and the percentage agreement. RESULTS: Two physiotherapists independently assessed 45 children and youths (age 4–19 years). The interrater reliability of the VDMS was substantial to almost perfect (Gwet’s alpha one: 0.66–0.99, n= 45) while the test-retest reliability was almost perfect as well (Gwet’s alpha one: 0.83–1.00, n= 42). CONCLUSION: The VDMS can be recommended as a reliable assessment with a standardized procedure to assess spasticity of the extremitie...
Advances in Neurodevelopmental Disorders, 2021
Objectives The techniques facilitation of activities, arrangement of task or situation, verbal an... more Objectives The techniques facilitation of activities, arrangement of task or situation, verbal and non-verbal communication, and counseling and empowerment of parents and caregivers are applied in different therapy approaches to improve motor function in children with neuromotor disorders. This review quantitatively examines the effectiveness of these four techniques allocated to pre-defined age groups and levels of disability. Methods We followed the systematic review methodology proposed by the American Academy for Cerebral Palsy and Developmental Medicine (AACPDM). The search was conducted on PubMed, Scopus, EMBASE, PEDro, OT Seeker, ERIC, and CINAHL. The main outcomes of the included articles were allocated to the framework of the International Classification of Functioning, Disability, and Health (body functions, activities, and participation). Results The search yielded eleven studies for facilitation, 22 for arrangement of task or situation, three for verbal and non-verbal co...
Therapie zur Verbesserung alltagsrelevanter Transfers
Therapeutisches Arbeiten in der Neuroorthopädie, 2021
Interventionen früh beginnen – Mobilität von Kindern mit Zerebralparese
physiopraxis, 2021
Die Zerebralparese ist die häufigste Ursache für körperliche Behinderungen im frühen Kindesalter.... more Die Zerebralparese ist die häufigste Ursache für körperliche Behinderungen im frühen Kindesalter. Sie begleitet die betroffenen Menschen für den Rest ihres Lebens. In diesem Überblick erfahren Sie, wie sich die Mobilität bei Zerebralparese entwickeln kann und wie wichtig es ist, dass auch Kinder schon frühzeitig ihr größtmögliches Potenzial ausschöpfen.
Hypertonia Assessment Tool--German Version
PsycTESTS Dataset, 2014
Developmental Medicine & Child Neurology, 2018
AIM: As there is little evidence for concurrent validity of the Eating and Drinking Ability Class... more AIM: As there is little evidence for concurrent validity of the Eating and Drinking Ability Classification System (EDACS), this study aimed to determine its concurrent validity and reliability in children and adolescents with cerebral palsy (CP). METHOD: After an extensive translation procedure, we applied the German language version to 52 participants with CP (30 males, 22 females, mean age 9y 7mo [SD 4y 2mo]). We correlated (Kendall's tau or K) the EDACS levels with the Bogenhausener Dysphagiescore (BODS), and the EDACS level of assistance with the Manual Ability Classification System (MACS) and the item 'eating' of the Functional Independence Measure for Children (WeeFIM). We further quantified the interrater reliability between speech and language therapists (SaLTs) and between SaLTs and parents with Kappa (). RESULTS: The EDACS levels correlated highly with the BODS (K =0.79), and the EDACS level of assistance correlated highly with the MACS (K =0.73) and WeeFIM eating item (K =-0.80). Interrater reliability proved almost perfect between SaLTs (EDACS: =0.94; EDACS level of assistance: =0.89) and SaLTs and parents (EDACS: =0.82; EDACS level of assistance: =0.89). INTERPRETATION: The EDACS levels and level of assistance seem valid and showed almost perfect interrater reliability when classifying eating and drinking problems in children and adolescents with CP. WHAT THIS PAPER ADDS: The Eating and Drinking Ability Classification System (EDACS) correlates well with a dysphagia score. The EDACS level of assistance proves valid. The German version of EDACS is highly reliable. EDACS correlates moderately to highly with other classification systems.
Disability and Rehabilitation, 2017
PURPOSE: We investigated the combined impact of trunk control and lower extremities impairments o... more PURPOSE: We investigated the combined impact of trunk control and lower extremities impairments on predicting gait capacity in children with cerebral palsy (CP) and evaluated relationships between trunk control and lower extremities impairments. METHODS: Data of 52 children with CP [29 boys, mean age 11 years 9 months (±4 years 6 months)] were included in this observational study. Gait capacity was measured by the "modified Time Up and Go test". Experienced therapists performed the "Modified Ashworth Scale", "Manual Muscle Test", the "Selective Control Assessment of the Lower Extremity", and the "Trunk Control Measurement Scale". We calculated Spearman correlations coefficients () and performed regression analyses. RESULTS: Trunk control was the strongest predictor ( = -0.624, p < 0.001) when explaining the variance of gait capacity and remained in the model together with spasticity (R2 = 0.67). Muscle strength and selectivity correlated moderately to strongly with the trunk control and gait capacity (-0.68 -0.78), but correlations for the spasticity were low (<-0.3). CONCLUSIONS: The interconnection between trunk control, leg muscle strength and selectivity for gait capacity in children with CP was shown. It indicates the significance of these impairments in gait assessment and, potentially, rehabilitation. Implications for Rehabilitation Trunk control was the strongest predictor for gait capacity in a regression model with lower extremity spasticity, muscle strength and selectivity and age as independent variables. Lower extremity muscle strength, selectivity, and trunk control explained a similar amount of gait capacity variance which is higher than that explained by lower extremity spasticity. Lower extremity muscle strength and selectivity correlated strongly with trunk control. Therefore, we cautiously suggest that a combined trunk control and lower extremity training might be promising for improving gait capacity in children with CP (Gross Motor Function Classification System level I-III), which needed to be tested in future intervention-studies.
Developmental Medicine & Child Neurology, 2017
This study investigated the intra-and interrater reliability of the Trunk Control Measurement Sca... more This study investigated the intra-and interrater reliability of the Trunk Control Measurement Scale (TCMS) German version, with its subscores, in children with neuromotor disorders. Further, the discriminative validity of the TCMS was assessed by comparing the TCMS scores with the Functional Independence Measure for children. METHOD: Bland-Altman analyses and intraclass correlation coefficients were applied to investigate reliability. The discriminative ability of the TCMS was evaluated with receiver operating characteristics. RESULTS: Ninety children (mean age 11y 5mo; range 5y-18y 11mo) participated for the reliability, and 50 for the discriminative validity study. The reliability proved to be excellent (intrarater: bias=0.57 points, 95% confidence interval [CI] -3.71 to 4.85; interrater: bias=-0.31 points, 95% CI -5.77 to 5.10). A change in the TCMS total score of six points (10%) can be considered a true change. The TCMS subscores appeared to be clinically relevant because children with less than around 80% of the static balance score, less than 55% of the dynamic reaching score, or less than around 35% of the selective movement control score needed support for daily life activities. INTERPRETA-TION: The TCMS is a reliable and clinically relevant assessment for children aged 5 years and older with different neurological impairments.
Hypertonia Assessment Tool
Journal of Child Neurology, 2016
The Hypertonia Assessment Tool is a 7-item instrument that discriminates spasticity, dystonia, an... more The Hypertonia Assessment Tool is a 7-item instrument that discriminates spasticity, dystonia, and rigidity on 3 levels: item scores, subtype, and hypertonia diagnosis for each extremity. We quantified the inter- and intrarater reliability using Kappa statistics, Gwet’s first-order agreement coefficient (both with 95% confidence interval), and percentage agreement for all levels. For validity, we compared the Hypertonia Assessment Tool subtype with the clinical diagnosis provided by the physicians. Two physiotherapists tested 45 children with neuromotor disorders. The interrater reliability (n = 45) of the Hypertonia Assessment Tool subtype was moderate to substantial whereas the intrarater reliability (n = 42) was almost perfect. The Hypertonia Assessment Tool showed good agreement in detecting spasticity. On the contrary, there was a higher presence of dystonia of 24% to 25% tested with the Hypertonia Assessment Tool compared to the clinical diagnosis. Even some individual items s...
European Journal of Paediatric Neurology, 2015
In this paper, we give some applications of a Newtontype method for constrained nonsmooth equatio... more In this paper, we give some applications of a Newtontype method for constrained nonsmooth equations. The method is proposed by F.Facchinei and etc, which use linear programming model for the solution of constrained nonsmooth equations. The applications of the method including in solving constrained maximum equations and generalized complementarity problems.
Research in Developmental Disabilities, 2015
Childhood cerebral palsy and the use of positioning systems to control body posture: Current prac... more Childhood cerebral palsy and the use of positioning systems to control body posture: Current practices.
Construct validity and reliability of the Selective Control Assessment of the Lower Extremity in children with cerebral palsy
Developmental Medicine & Child Neurology, 2015
Assessing impaired selective voluntary movement control in children with cerebral palsy (CP) has ... more Assessing impaired selective voluntary movement control in children with cerebral palsy (CP) has gained increasing interest. We investigated construct validity and intra- and interrater reliability of the Selective Control Assessment of the Lower Extremity (SCALE). Thirty-nine children (21 males, 18 females) with spastic CP, mean age 12 years 6 months [range 6y 11mo-19y 9mo], Gross Motor Function Classification System (GMFCS) levels I to IV, participated. Differences in SCALE scores were determined on joint levels and between patients categorized according to their limb distribution and GMFCS levels. SCALE scores were correlated with the Fugl-Meyer Assessment, Manual Muscle Test, and Modified Ashworth Scale. To determine reliability, the SCALE was applied once and recorded on video. SCALE scores differed significantly between the less and more affected leg (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001) and between most leg joints. Total SCALE scores differed significantly between GMFCS levels I and II. Correlations with Fugl-Meyer Assessment, Manual Muscle Test, and Modified Ashworth Scale were 0.88, 0.88, and -0.55 respectively. Intraclass correlation coefficients were all above 0.9, with the minimal detectable change below 2 points. The SCALE appears to be a valid and reliable tool to assess selective voluntary movement control of the legs in children with spastic CP.
Reliability and practicability of the straight leg raise test in children with cerebral palsy
Developmental Medicine & Child Neurology, 2015
Preventing restrictions to lower limb movement is part of the treatment given to children with ce... more Preventing restrictions to lower limb movement is part of the treatment given to children with cerebral palsy (CP). Such restrictions can be assessed using the &amp;amp;amp;#39;straight leg raise&amp;amp;amp;#39; (SLR) test. This study investigated the interrater reliability and practicability of the SLR test in children with CP. Experienced physiotherapists examined 23 children with CP (6-18y; eight females, 15 males) twice. The SLR hip range of motion (ROM) was measured using an electrogoniometer, and the test was rated based on sensitizing manoeuvres and biceps femoris muscle activity. Practicability was investigated by evaluating children&amp;amp;amp;#39;s subjective feedback on the tolerable ROM. Intraclass correlation coefficients for the SLR hip ROM varied, ranging from 0.84 (95% CI 0.61-0.93) to 0.93 (95% CI 0.87-0.96). Physiotherapists substantially agreed on SLR ratings (Cohen&amp;amp;amp;#39;s kappa=0.73). Biceps femoris muscle activity decreased significantly with the release of tension on the sciatic nerve. All children were able to communicate the location and sensation of the maximally tolerated position. The SLR test proved to be reliable and practicable in children with CP and might improve clinical reasoning processes. Lower limb movement restrictions in these children may partly be related to limitations in sciatic nerve mobility. Further studies should investigate if the SLR test could estimate activities in children with CP.
BMC Neurology
Background: In children with cerebral palsy (CP), stiffness, caused by contractile and non-contra... more Background: In children with cerebral palsy (CP), stiffness, caused by contractile and non-contractile structures, can influence motor performance. This study sought to determine whether the nerve mobility had a relevant impact on motor performance in children with CP. We hypothesized that a positive Straight Leg Raise (SLR) test, as well as smaller SLR hip angle, would relate to lower leg muscle strength, reduced motor capacity and less motor performance in children with CP. Methods: We applied a cross-sectional analysis on data including SLR, leg muscle strength, Gross Motor Function Measure (GMFM-66) and number of activity counts during daily life from thirty children with CP (6-18 years). We performed receiver operating characteristics and correlation analyses. Results: Positive SLR test could distinguish well between children with low versus high muscle strength and GMFM-66 scores. The SLR hip angle correlated significant with the level of disability and with muscle strength. The correlation with the GMFM-66 and the activity counts was fair. Conclusion: This study suggests that neural restriction of SLR is higher on functional and activity outcome than the measured SLR hip range of motion. Further studies should investigate weather improving nerve mobility can lead to an amelioration of function in children with CP.