Computerized Adaptive Tests Detect Change Following Orthopaedic Surgery in Youth with Cerebral Palsy.

Authors

M J Mulcahey, Department of Occupational Therapy, School of Health Professions, Thomas Jefferson UniversityFollow
Mary D Slavin, Health and Disability Research Institute, School of Public Health, Boston University
Pengsheng Ni, Health and Disability Research Institute, School of Public Health, Boston UniversityFollow
Lawrence C Vogel, Shriners Hospitals for Children, Chicago, Illinois
Scott H Kozin, Shriners Hospitals for Children, Philadelphia, PennsylvaniaFollow
Stephen M Haley
Alan M Jette, Health and Disability Research Institute, School of Public Health, Boston UniversityFollow

Document Type

Article

Publication Date

9-16-2015

Comments

This article has been peer reviewed. It was published in: The Journal of Bone and Joint Surgery. American volume.

Volume 97, Issue 18, 16 September 2015, Pages 1482-1494.

The published version is available at DOI: 10.2106/JBJS.O.00179

Copyright © 2015 by The Journal of Bone and Joint Surgery, Incorporated.

Abstract

BACKGROUND: The Cerebral Palsy Computerized Adaptive Test (CP-CAT) is a parent-reported outcomes instrument for measuring lower and upper-extremity function, activity, and global health across impairment levels and a broad age range of children with cerebral palsy (CP). This study was performed to examine whether the Lower Extremity/Mobility (LE) CP-CAT detects change in mobility following orthopaedic surgery in children with CP.

METHODS: This multicenter, longitudinal study involved administration of the LE CP-CAT, the Pediatric Outcomes Data Collection Instrument (PODCI) Transfer/Mobility and Sports/Physical Functioning domains, and the Timed "Up & Go" test (TUG) before and after elective orthopaedic surgery in a convenience sample of 255 children, four to twenty years of age, who had CP and a Gross Motor Function Classification System (GMFCS) level of I, II, or III. Standardized response means (SRMs) and 95% confidence intervals (CIs) were calculated for all measures at six, twelve, and twenty-four months following surgery.

RESULTS: SRM estimates for the LE CP-CAT were significantly greater than the SRM estimates for the PODCI Transfer/Mobility domain at twelve months, the PODCI Sports/Physical Functioning domain at twelve months, and the TUG at twelve and twenty-four months. When the results for the children at GMFCS levels I, II, and III were grouped together, the improvements in function detected by the LE CP-CAT at twelve and twenty-four months were found to be greater than the changes detected by the PODCI Transfer/Mobility and Sports/Physical Functioning scales. The LE CP-CAT outperformed the PODCI scales for GMFCS levels I and III at both of these follow-up intervals; none of the scales performed well for patients with GMFCS level II.

CONCLUSIONS: The results of this study showed that the LE CP-CAT displayed superior sensitivity to change than the PODCI and TUG scales after musculoskeletal surgery in children with CP.

Recommended Citation

Mulcahey, M J; Slavin, Mary D; Ni, Pengsheng; Vogel, Lawrence C; Kozin, Scott H; Haley, Stephen M; and Jette, Alan M, "Computerized Adaptive Tests Detect Change Following Orthopaedic Surgery in Youth with Cerebral Palsy." (2015). Department of Occupational Therapy Faculty Papers. Paper 58.
https://jdc.jefferson.edu/otfp/58

PubMed ID

26378264