The Seated Postural & Reaching Control Test in Cerebral Palsy: A Validation Study

Abstract

Aim: Children with moderate-severe cerebral palsy (CP) show postural control deficits that affect their daily activities, like reaching. The Seated Postural and Reaching Control test (SP&R-co) was developed to address the need for clinical measures that objectively identify dimensions of postural imbalance and corresponding reaching limitations in children with CP.

Methods: SP&R-co documentation was designed for test validity and rater training. Rater and internal consistency were examined using Cronbach’s α. Reference SP&R-co score sheets of children and rater’s scores were used for absolute item-by-item, average inter-rater, and intra-rater reliability. Motor classification systems and performance tests were used for construct and concurrent validity.

Results: The SP&R-co scoring showed acceptable-good consistency (α = 0.76–0.84). Interrelatedness of SP&R-co items was good-excellent (α = 0.82–0.97). The raters demonstrated fair, good, and excellent item-by-item reliability (ICC = 0.41–0.92). Inter-rater and intra-rater reliability of SP&R-co dimensions were good-excellent (ICC = 0.68–0.86 and ICC = 0.64–0.95, respectively). Construct and concurrent validity showed moderate-excellent correlations (r = 0.49–0.88).

Conclusions: Results provide evidence that the SP&R-co is a reliable and valid test for therapists to objectively examine and quantify seated postural and reaching control in children with CP.

Keywords:

• Assessment
• cerebral palsy
• posture
• reaching
• sitting

Acknowledgments

The authors would like to recognize the valuable research contributions from Dr. Anne Shumway-Cook. We thank the three physical therapists for their participation as raters. We thank all the families who participated in the study.

Disclosure statement

There is no conflict of interest to report.

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

This study was funded by the National Institute of Health Grant R01HD062745-01, Dr. Marjorie Woollacott, and the Langer Foundation, administered by The Order of Malta, Drs. Andrew Gordon and Joseph Dutkowsky.

Notes on contributors

Victor Santamaria

Victor Santamaria is a postdoctoral research scientist with Dr. Sunil Agrawal in the ROobotics And Rehabilitation (ROAR) laboratory, Mechanical Engineering department at Columbia University. Santamaria is also a licensed physical therapist specialized in pediatric rehabilitation. He received his Ph.D from University of Oregon, under the supervision of Dr. Marjorie Woollacott, and his post-doctoral training from Teachers College, Columbia University, advised by Dr. Andrew Gordon. His research focuses on the application of motor learning and control principles in clinical evaluations, therapeutic programs, and robotics rehabilitation paradigms.

Jaya Rachwani

Jaya Rachwani is assistant professor at the Department of Physical Therapy, Hunter College, City University of New York. Rachwani is a licensed physical therapist specialized in pediatric rehabilitation. She received her Ph.D at the University of Oregon under the supervision of Dr. Marjorie Woollacott and her postdoctoral training with Dr. Karen Adolph at New York University. Her research focuses on the development of postural control and the coordination of visual and manual actions.

Geoffroy Saussez

Geoffroy Saussez is a physical therapist and PhD student at the Université Catholique de Louvain, Institute of Neuroscience. His research focuses on motor control and motor learning principles applied in clinical interventions and virtual interactive devices for children with cerebral palsy.

Yannick Bleyenheuft

Yannick Bleyenheuft is a professor at the Université catholique de Louvain, Institute of Neuroscience, has a Ph.D in movement sciences, and a master in physical therapy and rehabilitation. Her research focuses on motor-learning based interventions for children with cerebral palsy.

Joseph Dutkowsky

Joseph Dutkowsky is pediatric orthopedic surgeon who specializes in the care of persons with childhood onset disabilities across the lifespan. His primary collaborative research focuses on the motor and functional life transition of children with cerebral palsy to adulthood.

Andrew M. Gordon

Andrew M. Gordon is a professor of Movement Science at Teachers College, Columbia University and founder of the Center for Cerebral Palsy Research. He is a senior researcher in motor control of upper limbs and motor-learning based upper limb interventions for children with cerebral palsy.

Marjorie H. Woollacott

Marjorie H. Woollacott is an emeritus professor of Human Physiology and a member of the Institute of Neuroscience at the University of Oregon. She is a senior researcher in the area of motor control and development. She is a world expert in postural control and co-author, with Dr. Anne Shumway-Cook, of the book, “Motor Control: Translating Research into Clinical Practice.”