Development of a parent-reported questionnaire evaluating upper limb activity limitation in children with cerebral palsy.
N Preston, M Horton, M Levesley and 2 others
PMID 28112465WHAT IT FOUND
A parent-completed 19-item questionnaire for children with cerebral palsy covered upper limb activity from severe to mild limits.
It can be completed at home, but change after therapy has not yet been tested.
Key findings
01The final ChARM had 19 items and showed acceptable evidence that the items measured one main activity-limitation trait.
02Sixteen children (12%) scored outside the measurement range, but this proportion did not represent a floor or ceiling effect.
03No parent reported taking longer than 4 minutes to complete the ChARM.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The ChARM has not been tested for responsiveness, so it cannot yet show whether it detects change after therapy. Final calibration used 132 of the 148 returned questionnaires because 16 children scored outside the measurement range. The researchers did not know how many questionnaires were posted, so the response rate is unknown. Item development relied on goals from 53 children, fewer than anticipated, and an unknown number of parents may have been excluded by therapist judgement. Only five children at MACS Level V were represented on the scale, and all had learning disability. Children with MACS Level I were included even though the questionnaire was intended for upper limb activity limitation.
Declared interests
The paper reports funding by the National Institute for Health Research under a Doctoral Fellowship programme and does not mention commercial funding or author conflicts.
The easy way to misread this
Do not conclude that the ChARM has been shown to detect change after therapy. It is a questionnaire development and validation paper, and responsiveness has not yet been tested.