Yonsei Med J.  2015 Jan;56(1):271-276. 10.3349/ymj.2015.56.1.271.

Reliability and Validity of the Upper Limb Physician's Rating Scale in Children with Cerebral Palsy

• Park ES
• Joo JW
• Kim SA
• Rha DW
• Jung SJ

• KMID: 2352816
• DOI: http://doi.org/10.3349/ymj.2015.56.1.271

Abstract

PURPOSE
The Upper Limb Physician's Rating Scale (ULPRS) is a tool that assesses movement quality of the upper limbs. It is used as an outcome measure after botulinum toxin type A injection in children with cerebral palsy (CP). This study aimed to investigate the reliability and validity of the ULPRS in children with spastic CP.
MATERIALS AND METHODS
Thirty children with spastic CP (M:F=17:13) aged 5 to 13 years old were recruited. The ULPRS was scored based on recorded videotapes by four physicians on two separate occasions. The Melbourne Assessment of Unilateral Upper Limb Function (MUUL) was scored by an occupational therapist. Intraclass correlation coefficients (ICCs), 95% confidence intervals and weighted kappa statistics were calculated for the scores of ULPRS to obtain interrater and intrarater reliability. The relationship between ULPRS and MUUL was assessed using Pearson correlation coefficients.
RESULTS
The ICCs for the total ULPRS scores were 0.94 between raters and 0.99 to 1.00 within raters. The weighted kappa statistics for subitem scores for the ULPRS ranged from 0.67 to 1.00 within raters and from 0.46 to 0.86 between raters. The relationship between ULPRS and MUUL was strong (Pearson correlation coefficient=0.751; p<0.05).
CONCLUSION
The results demonstrated the high reliability of the total ULPRS score within and between raters. A significant concurrent validity between ULPRS and MUUL also supports the clinical utility of the ULPRS as an outcome measure of spastic upper limb in children with CP.

Keyword

Upper extremity; botulinum toxin type A injection; outcome measure; Melbourne assessment; unilateral upper limb function

MeSH Terms

Adolescent
Arm/*physiopathology
Cerebral Palsy/*physiopathology
Child
Child, Preschool
Female
Humans
Male
*Physicians
Reproducibility of Results

Figure

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  Fig. 1 Repeat score differences for each rater. Mean: repeat score mean; difference: repeat-score difference; dotted line: median of repeat-score difference; middle solid line: mean of repeat-score difference; top and bottom solid line: 95% limits of agreement for the repeat-score difference.

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