Measurement Properties and Translation to Brazilian-Portuguese of the Challenge for Children and Adolescents with Cerebral Palsy

Abstract

Aims: Translate the Challenge assessment into Brazilian-Portuguese, determine its face validity, evaluate the reliability of the total score and score per item, investigate whether the child’s gross motor level (classified by the Gross Motor Function Classification System-GMFCS) influences the reliability levels, and estimate responsiveness to change.

Methods: The translation followed four stages: translation, synthesis, back-translation, and review. For face validity, ten physical therapists evaluated item relevance. Children and adolescents with cerebral palsy (n = 50, 5-18 years of age) GMFCS I and II were evaluated by two therapists for inter and intra-rater reliability. Thirty of these participants were recruited for the instrument's responsiveness evaluation and reassessed (n = 28) after three months of treatment. Minimal Detectable Change (MDC), and Minimal Clinically Important Difference (MCID) were estimated.

Results: The back-translated version was similar to the English version. All test items were considered relevant by the physical therapists. Total score intra and inter-rater reliability were excellent for both GMFCS levels (ICC = 0.94-0.99). Items’ intra- and inter- rater reliability varied from low to almost perfect (kw=-0.14-0.94). MDC90 and MDC95 values were 3.90-6.35 and 4.63-7.54, respectively. MCID values were 3.57-4.56.

Conclusion: The translated version of the Challenge showed excellent face validity and reliability and was able to document longitudinal change.

Keywords:

• Cerebral palsy
• gross motor function
• psychometric properties
• cross-cultural translation
• responsiveness
• minimal clinically important difference

Disclosure statement

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

Additional information

Notes on contributors

Ricardo Rodrigues Sousa Junior

Ricardo Rodrigues Sousa Junior, MSc, PT, Bachelor's degree in Physical Therapy (2011) and Masters of Sciences degree in Rehabilitation Sciences (2019) from Universidade Federal de Minas Gerais (UFMG), Brazil. He was an exchange student scholarship recipient from the Brazilian Scientific Mobility Program (2015) at New York Institute of Technology and Columbia University, United States. He participated in the fellowship program in Pediatric Rehabilitation (2017) at the Associação Mineira de Reabilitação, Brazil.

Ana Paula Bensemann Gontijo

Ana Paula Bensemann Gontijo, PhD, PT, Professor of the Physical Therapy Department at the Universidade Federal de Minas Gerais (UFMG), Brazil. She has a Bachelor's degree in Physical Therapy from UFMG (1986), Advanced Master's in Rehabilitation Sciences at UFMG, Brazil (2005), ScD in Rehabilitation Sciences at UFMG, Brazil (2012). She has expertise in the following subjects: typical and atypical child development, cerebral palsy, Down syndrome, neuromuscular diseases, functional evaluation of children with disabilities.

Thiago Ribeiro Teles Santos

Thiago Ribeiro Teles Santos, PhD, PT, Post-doc researcher in Rehabilitation Sciences in the Graduate Program of Rehabilitation Sciences, at the Universidade Federal de Minas Gerais (UFMG), Brazil. Physical Therapy faculty at Centro Universitário de Belo Horizonte (UniBH), Brazil. He received the bachelor's degree in Physical Therapy in 2008, the master's degree in 2011 and Ph.D. in 2016, all the graduate degrees I Rehabilitation Sciences, UFMG. During 2014, he was a PhD visiting student at Wyss Institute – Harvard University, USA. His research focuses on biomechanics, locomotion, rehabilitation and motor control.

F. Virginia Wright

F. Virginia Wright, PhD, PT, is Senior Scientist, Bloorview Research Institute, Toronto, Canada and Professor (status), Department of Physical Therapy, University of Toronto. She holds the Holland Bloorview Childrens Hospital Foundation Chair in Pediatric Rehabilitation.

Marisa C. Mancini

Marisa C. Mancini, ScD, OT, Full Professor in the Occupational Therapy Department and faculty of the Graduate Program in Rehabilitation Sciences, at the Universidade Federal de Minas Gerais (UFMG), Brazil. Bachelor's degree in Occupational Therapy from UFMG (1986), Advanced Master's in Rehabilitation Sciences at the University of Alberta, Canada (1989), ScD in Rehabilitation Sciences at Boston University, USA (1997) and two visiting scholar experiences at the University of Connecticut (2005) and at Aix-Marseille Université, France (2015). She was Chief Editor of the Brazilian Journal of Physical Therapy (BJPT) (2011-2014). She is member of the editorial board of the BJPT and Annals of International Occupational Therapy. Research fellowship from the Brazilian National Research funding agency (CNPq) and has expertise in the following subjects: child development, cerebral palsy, functional evaluation of children with disabilities, human functioning and disablement processes.