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

Figures & data

Table 1. Characteristics of the participants.

	Validity (n = 30)	Intra-, inter-rater reliability (n = 46)	Test–retest reliability (n = 27)
Sex
Males	22	31	18
Females	8	15	9
Diagnosis
Unilateral spastic CP	3	5	2
Bilateral spastic CP	9	16	11
CP other^a	4	6	4
Encephalitis	6	6	1
Stroke ischemic	4	7	5
Stroke hemorrhagic	1	2	1
Traumatic brain injury	2	3	3
Epilepsy	1	1	–
MACS
I	10	11	6
II	16	24	14
III	3	9	6
IV	1	2	1
More affected side
Left	23	32	17
Right	7	14	10
Dominant side
Left	8	15	11
Right	22	31	16

MACS: Manual Ability Classification System.

^aCP other were children with a mixed spastic-dystonic (n = 1) or spastic-ataxic (n = 3) cerebral palsy.

Figure 1. Validity and reliability of SCUES limb scores of the more affected side. Scatterplots showing the relationship between the SCUES and (A) the sum of the Melbourne Assessment 2 range of motion items (MA2) and (B) the Box and Block Test (BBT). Scatterplots C–E show the reliability findings for the (C) intra-rater, (D) inter-rater, and (E) test–retest reliability. In (D), we presented the results for comparing raters 1 and 2 in black and raters 1 and 3 in grey. Note that this was done for visual interpretation only (statistics were performed as described in the methods section). Different signs reflect different diagnoses. “CP other” were children with a mixed spastic-dystonic or spastic-ataxic cerebral palsy. SCUES: Selective Control of the Upper Extremity Scale; CP: cerebral palsy; TBI: traumatic brain injury.

Table 2. Median (IQR) SCUES and MA2 scores and correlations for the more and less affected side.

Items SCUES	Items MA2	More affected side			Less Affected side			SCUES Diff.^a
		SCUES	MA2	ρ (95%CI)^a p-value	SCUES	MA2	ρ (95%CI)^a p-value	Z-value p-value
Shoulder	2. Reach sideways to elevated position	2 (2–3)	3 (2–3)	0.65 (0.46 to 0.80) p < 0.001	3 (2–3)	3 (3–3)	0.45 (−0.11 to 0.76) p = 0.01	−4.00 p < 0.001
Elbow	14. Hand to mouth and down	2 (2–3)	3 (2–3)	0.58 (0.26 to 0.82) p = 0.001	3 (2–3)	3 (2.75–3)	0.30 (−0.18 to 0.67) p = 0.11	−3.69 p < 0.001
Forearm	12. Pronation / Supination	2 (2–3)	4 (4–4)	0.39 (−0.07 to 0.70) p = 0.03	2.5 (2–3)	4 (4–4)	0.19 (–) p = 0.33)	−3.65 p < 0.001
Wrist	7. Release of pellet	2 (2–2)	3 (2–3)	0.62 (0.41 to 0.77) p < 0.001	2.5 (2–3)	3 (3–3)	0.53 (0.29 to 0.70) p = 0.003	−3.46 p = 0.001
Fingers/Thumb	5. Release of crayon	2 (2–3)	3 (2–3)	0.51 (0.19 to 0.74) p = 0.004	3 (2–3)	3 (3–3)	0.23 (−0.22 to 0.58) p = 0.22	Z= −3.16 p = 0.002
Sum	Sum items 2, 14, 12, 7, and 5	11 (9.75–13.25)	15 (11.75–16.00)	0.77 (0.56 to 0.88) p < 0.001	13 (11–15)	16 (15–16)	0.46 (0.15 to 0.69) p = 0.01	−4.87 p < 0.001
Sum	Total MA2 ROM subscale score		24 (18.25–26.25)	0.83 (0.69 to 0.91) p < 0.001		25.5 (24-27)	0.70 (0.42 to 0.88) p < 0.001

The SCUES and the MA2 were tested on the same day, except for one participant where the MA2 was performed one day later. Unlike the SCUES limb and BBT scores, the MA2 data were not normally distributed. SCUES: Selective Control of the Upper Extremity Scale; MA2: Melbourne Assessment 2; ROM: range of motion; ρ: non-parametric Spearman’s correlation.

^aSCUES Diff. shows the Z-values of the Wilcoxon signed-rank tests and the p-values calculated for the differences between the SCUES scores of the more and less affected side.

Table 3. Reliability of SCUES limb and item scores.

	Intra-rater				Inter-rater				Test–retest
	More affected		Less affected		More affected		Less affected		More affected		Less affected
SCUES	ICC	SDC	ICC	SDC	ICC	SDC	ICC	SDC	ICC	SDC	ICC	SDC
Shoulder	0.91	0.58	0.81	0.82	0.66	1.13	0.68	1.03	0.82	0.85	0.84	0.71
Elbow	0.98	0.29	0.79	0.76	0.64	1.11	0.60	0.97	0.82	0.85	0.80	0.75
Forearm	0.87	0.96	0.93	0.41	0.82	1.16	0.60	1.00	0.89	0.99	0.70	1.01
Wrist	0.81	1.01	0.97	0.29	0.80	1.16	0.67	1.00	0.84	1.12	0.94	0.44
Fingers/ Thumb	0.90	0.71	0.85	0.65	0.77	1.13	0.64	1.03	0.89	0.82	0.67	0.96
Limb score	0.93	2.55	0.97	1.13	0.86	3.58	0.78	3.05	0.98	1.41	0.95	1.62

SCUES: Selective Control of the Upper Extremity Scale; ICC: intra-class correlation coefficient; SDC: smallest detectable change.