Validity and reliability of the Selective Control of the Upper Extremity Scale in children with upper motor neuron lesions

Abstract

Purpose

We evaluated the validity and intra-, inter-, and test–retest reliability of the Selective Control of the Upper Extremity Scale (SCUES) sum and item scores in patients with upper motor neuron lesions.

Methods

Thirty-one boys and 15 girls (mean age ± SD: 11 years 1 month ± 3 years 9 month) with upper motor neuron lesions participated. We correlated SCUES scores with the range of motion items of the Melbourne Assessment 2 (MA2) and Box and Block Test (BBT) to establish concurrent validity and compared scores between the more and less affected side for discriminative validity. Intra-class correlation coefficients (ICC) and smallest detectable changes (SDC) indicated relative and absolute reliability.

Results

For the more affected side, SCUES sum scores correlated well with MA2 (ρ = 0.83) and BBT (ρ = 0.77), and reliability proved high for intra-rater (ICC = 0.93, SDC = 2.55), inter-rater (ICC = 0.86, SDC = 3.58), and test–retest (ICC = 0.98, SDC = 1.41) reliability. Reliability of single items varied from 0.64 (inter-rater elbow) to 0.98 (intra-rater elbow). Limb and item scores were lower for the more affected side.

Conclusion

The SCUES limb and item scores seem valid and reliable in children with upper motor neuron lesions. While future studies should evaluate the responsiveness of the SCUES, we recommend that the same rater should score a patient twice.

Implications for rehabilitation

• The SCUES assesses selective voluntary motor control and appears valid and reliable in patients with upper motor neuron lesions.

• Test–retest reliability of the SCUES seems excellent.

• SCUES single item scores show concurrent validity and acceptable reliability.

• Limb and item scores are significantly lower for the more affected side.

Keywords:

• Cerebral palsy
• children with disability
• psychometrics
• reliability and validity
• selective motor control
• stroke

Acknowledgments

The authors greatly appreciate the participation of the children and their parents, who provided approval. This work could not have been done without the help of the occupational therapists Annina Herzog and Esther Zamarrón of the Swiss Children’s Rehab, as well as Annina Fahr and Julia Balzer of the Research Department, who assisted in some of the measurements. The authors are grateful to Lisa Wagner and Jon Davids, who developed the SCUES, for their feedback during the translation procedure. The authors are also grateful to Mrs Beate Gartmann, who performed one of the translations. The authors thank the reviewers for their constructive feedback.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This study was financially supported by the Swiss National Science Foundation (Projects 32003B_156646 and 32003B_179471), the J&K Wonderland Foundation (Steinhausen, Switzerland), and the Mäxi Foundation (Zurich, Switzerland).