Reliability and validity of the Japanese version of the selective control assessment of the lower extremity tool among patients with spastic cerebral palsy.
Yasuaki Kusumoto, Mami Hanao, Kenji Takaki and 2 others
PMID 28174443WHAT IT FOUND
The Japanese version of the SCALE tool reliably measures selective motor control in spastic cerebral palsy.
It takes 15 minutes, needs no special equipment, and scores track closely with GMFCS levels. Use it to assess lower-limb control, but it cannot be used for children under 6 or GMFCS level V.
Key findings
01The Japanese SCALE tool showed high reliability for both repeated testing by one therapist and testing by different therapists, with intraclass correlation coefficients ranging from 0.93 to 0.96.
02SCALE scores correlated strongly and inversely with GMFCS levels, meaning children with higher functional classification scores had lower selective motor control scores.
03The tool can be administered in 15 minutes without specialized equipment, but it requires the patient to follow simple motor instructions, excluding those under 6 years or with severe motor and intellectual disturbances.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study excluded children younger than 6 and individuals with GMFCS level V because they could not follow simple motor instructions or provide consent, limiting the tool's use in these groups. The sample was drawn from three hospitals in Tokyo and Kanagawa, which may not represent the broader population. There was notable variability in SCALE scores for participants at GMFCS level III, suggesting the tool may be less precise for distinguishing severity within this specific group.
Declared interests
The study was financially supported by a JSPS KAKENHI grant. All authors declared no conflicts of interest.
The easy way to misread this
Do not assume this tool is valid for all children with CP. It requires the ability to follow simple motor instructions, so it cannot be used for children under 6 years or those with severe motor and intellectual disturbances (GMFCS level V).