Responsiveness of the Seated Postural Control Measure and the Level of Sitting Scale in children with neuromotor disorders

Abstract

Purpose. Responsiveness of the Seated Postural Control Measure (SPCM) and the Level of Sitting Scale (LSS) was explored for children with neuromotor disorders. Total change scores for alignment (SPCM-A), function (SPCM-F) and sitting ability (LSS) were compared with a criterion change measure, the Global Change Scale (GCS). The a priori hypotheses predicted moderate correlations (r > 0.40).

Method. Both SPCM and LSS were administered twice, 6 months apart. Parents and two therapists rated changes in alignment and function, and indicated importance of those changes on the GCS. Participants (n = 114) were divided into two groups: those whose posture was expected to change, (with a range of diagnoses) and those who were expected to remain stable (with a diagnosis of cerebral palsy). Ages ranged from 1 to18 years.

Results. Fair-to-moderate significant correlations (p ≤ 0.01) were found between SPCM-F and LSS change scores and parents' and therapists' rating of change and importance of change on the GCS. Correlations for SPCM-A change scores were insignificant. The standardised response mean values for SPCM-F and LSS confirmed a minimal clinically important difference.

Conclusions. SPCM-F shows promise as a responsive outcome measure, however; SPCM-A requires further work. LSS may be useful for evaluative purposes, in addition to its role as a classification index.

Keywords:

• Seating
• sitting posture
• rehabilitation
• measurement tool

Acknowledgements

Much appreciation is extended to all the families and participants who so willingly gave their time. The authors thank all the therapists who assisted in identifying suitable candidates, as well as the assessors Roslyn Livingstone and Maureen Story. In addition, thanks go to Ruth Milner and Boris Kuzeljevic of the Children's and Women's Clinical Research Support Unit for their consultation on study design and statistical support for the data analysis. Gratitude is extended also to Lucy Cheng, a Masters student in the University of British Columbia Statistics Department who provided statistical support, and to Margaret Francis, Mara Damin and Andy Brule for their assistance with carrying out the project. Authors are very grateful to Dr. Susan Harris, Professor Emerita in the Department of Physical Therapy at the University of British Columbia, for her editorial support, and encouragement.

Declaration of interest: Authors are indebted to the British Columbia Medical Services Foundation for their financial support of this research.