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Measurement Characteristics and Clinical Utility of the Cerebral Palsy Profile of Health and Function Among Children With CP

Published:March 13, 2019DOI:https://doi.org/10.1016/j.apmr.2019.01.007
      Assessing physical function in children with cerebral palsy (CP) is critical in evaluating progression and effectiveness of medical, surgical and therapeutic treatments. Cerebral Palsy Profile of Health and Function (CP-PRO) is a parent-reported outcome measure, rating the parent’s perception of the child’s difficulty when performing physical activities.1
      The CP-PRO is a computer adaptive test (CAT) that first presents questions in the middle of the ability range, and then directs questions to the appropriate ability level based on the person’s response to previous items. The 5-, 10-, or 15-item CATs are reported to be as reliable as the full item bank.2. 3. 4. The CP-PRO includes 4 subscales of upper extremity, lower extremity, activity, and global physical health that can be administered independently. The CP-PRO has a 5-point difficulty scale: unable to do, with much difficulty, with some difficulty, with little difficulty, and without difficulty. The age range recommended for administration is 2 to 20 years.
      Haley et al5 examined 91 children with CP and reported excellent concurrent validity with legacy measures such as Functional Assessment Questionnaire (r=0.78), Pediatric Outcomes Data Collection Instrument basic mobility (r=0.88), and Wee-FIM motor (r=0.89). Haley et al5 additionally examined 27 children with CP and reported excellent test-retest reliability for overall (intraclass correlation coefficient [ICC]=0.91), Lower Extremity CP-PRO (ICC=0.96), Upper Extremity CP-PRO (ICC=0.86), Activity CP-PRO (ICC=0.88), and Global Physical Health CP-PRO (ICC=0.94). In sum, the reported reliability, validity, responsiveness, unidimensionality of the sub-scales, and time-efficient CAT format support clinical use of CP-PRO for children with CP.
      This abbreviated summary provides a review of the psychometric properties of Cerebral Palsy Profile of Health and Function in children with Cerebral Palsy. A full review of the of Cerebral Palsy Profile of Health and Function and reviews of over 400 other instruments for patients with various health conditions can be found at: www.sralab.org/Rehabilitation-Measures.
      Please address correspondence to [email protected] .
      This instrument summary is designed to facilitate the selection of outcome measures by clinicians. The information contained in this summary represents a sample of the peer-reviewed research available at the time of this summary’s publication. The information contained in this summary does not constitute an endorsement of this instrument for clinical practice. The views expressed are those of the summary authors and do not represent those of authors’ employers, instrument owner(s), the Archives of Physical Medicine and Rehabilitation, the Rehabilitation Measures Database or the United States Department of Health and Human Services. The information contained in this summary has not been reviewed externally.
      The Rehabilitation Measures Database and Instrument Summary Tear-sheets were initially funded by the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR), United States Department of Health and Human Services, through the Rehabilitation Research and Training Center on Improving Measurement of Medical Rehabilitation Outcomes (H133B090024).
      • 1.
        Dumas H, Watson K, Fragala-Pinkham MA, et al. Using cognitive interviewing for test items to assess physical function in children with cerebral palsy. Pediatric Phys Ther 2008;20:356-62.
      • 2.
        Tucker CA, Gorton GE, Watson K, et al. Development of a parent-report computer-adaptive test to assess physical functioning in children with cerebral palsy I: lower-extremity and mobility skills. Dev Med Child Neurol 2009;51:717-24.
      • 3.
        Tucker CA, Montpetit K, Bilodeau N, et al. Development of a parent-report computer-adaptive test to assess physical functioning in children with cerebral palsy II: upper-extremity skills. Dev Med Child Neurol 2009;51:725-31.
      • 4.
        Haley SM, Fragala-Pinkham MA, Dumas HM, et al. Evaluation of an item bank for a computerized adaptive test of activity in children with cerebral palsy. Phys Ther 2009;89:589-600.
      • 5.
        Haley SM, Chafetz RS, Tian F, et al. Validity and reliability of physical functioning computer-adaptive tests for children with cerebral palsy. J Pediatr Orthop 2010;30:71-5.
      • 6.
        Mulcahey MJ, Slavin, MD, Ni P, et al. Computer adaptive tests detect change following orthopaedic surgery in youth with cerebral palsy. J Bone Joint Surg Am 2015;97:1482-94.