Psychometric and Clinimetric Properties of the Melbourne Assessment 2 in Children With Cerebral Palsy

Tien-Ni Wang; Kai-Jie Liang; Yi-Chia Liu; Jeng-Yi Shieh; Hao-Ling Chen

doi:10.1016/j.apmr.2017.01.024

Psychometric and Clinimetric Properties of the Melbourne Assessment 2 in Children With Cerebral Palsy

Arch Phys Med Rehabil. 2017 Sep;98(9):1836-1841. doi: 10.1016/j.apmr.2017.01.024. Epub 2017 Feb 28.

Authors

Tien-Ni Wang¹, Kai-Jie Liang¹, Yi-Chia Liu¹, Jeng-Yi Shieh², Hao-Ling Chen³

Affiliations

¹ School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.
² Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan.
³ School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan. Electronic address: hlchen@ntu.edu.tw.

PMID: 28254639
DOI: 10.1016/j.apmr.2017.01.024

Abstract

Objective: To examine the psychometric and clinimetric properties of the Melbourne Assessment 2 (MA2), an outcome measurement that is increasingly used in clinical studies.

Design: Psychometric and clinimetric study.

Setting: Community.

Participants: Seventeen children with cerebral palsy (CP) from 5 to 12 years were recruited for the estimation of the test-retest reliability and minimal detectable change (MDC). Thirty-five children with CP were recruited to receive an 8-week intensive neurorehabilitation intervention to estimate the validity, responsiveness, and minimal clinically important difference (MCID).

Interventions: Thirty-five children with CP received upper limb neurorehabilitation programs for 8 weeks.

Main outcome measures: The MA2 and the criterion measures, including the Bruininks-Oseretsky Test of Motor Proficiency, 2nd edition (BOT-2), the Box and Blocks Test (BBT), and the Pediatric Motor Activity Log-Revised (PMAL-R), were evaluated at pretreatment and posttreatment.

Results: The MA2 has 4 subscales: range of motion, fluency, accuracy, and dexterity. The test-retest reliability of the MA2 is high (intraclass correlation coefficient, .92-.98). The significant relationships between the MA2 and BBT, BOT-2, and PMAL-R support its validity. The significance of paired t test results (P<.001) and large magnitudes of the standardized response mean (1.70-2.00) confirm the responsiveness of the MA2. The MDC values of the 4 subscales of the MA2 are 2.85, 1.63, 1.97, and 1.84, respectively, and the suggested MCID values of these 4 subscales are 2.35, 3.20, 2.09, and 2.22, respectively, indicating the minimum scores of improvement to be interpreted as both statistically significant and clinically important.

Conclusions: The study findings indicate that the MA2 has sound psychometric and clinimetric properties and is thus an adequate measurement for research and clinical applications.

Keywords: Cerebral palsy; Minimal clinically important difference; Psychometrics; Rehabilitation; Reproducibility of results.

Publication types

Validation Study

MeSH terms

Cerebral Palsy / psychology*
Cerebral Palsy / rehabilitation*
Child
Child, Preschool
Disability Evaluation*
Female
Humans
Male
Minimal Clinically Important Difference*
Neurological Rehabilitation / methods
Neurological Rehabilitation / statistics & numerical data
Psychometrics
Reproducibility of Results
Treatment Outcome
Upper Extremity
Victoria