Measurement properties of gait-related outcomes in youth with neuromuscular diagnoses: a systematic review.
BACKGROUND
Sound measurement properties of outcome tools are essential when evaluating outcomes of an intervention, in clinical practice and in research.


OBJECTIVE
The purpose of this study was to review the evidence on reliability, measurement error, and responsiveness of measures of gait function in children with neuromuscular diagnoses.


METHODS
The MEDLINE, CINAHL, EMBASE, and PsycINFO databases were searched up to June 15, 2012.


METHODS
Studies evaluating reliability, measurement error, or responsiveness of measures of gait function in 1- to 18-year-old children and youth with neuromuscular diagnoses were included.


METHODS
Quality of the studies was independently rated by 2 raters using a modified COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) checklist. Studies with a fair quality rating or better were considered for best evidence synthesis.


RESULTS
Regarding the methodological quality, 32 out of 35 reliability studies, all of the 13 measurement error studies, and 5 out of 10 responsiveness studies were of fair or good quality. Best evidence synthesis revealed moderate to strong evidence for reliability for several measures in children and youth with cerebral palsy (CP) but was limited or unknown in other diagnoses. The Functional Mobility Scale (FMS) and the Gross Motor Function Measure (GMFM) dimension E showed limited positive evidence for responsiveness in children with CP, but it was unknown or controversial in other diagnoses. No information was reported on the minimal important change; thus, evidence on measurement error remained undetermined.


CONCLUSIONS
As studies on validity were not included in the review, a comprehensive appraisal of the best available gait-related outcome measure per diagnosis is not possible.


CONCLUSIONS
There is moderate to strong evidence on reliability for several measures of gait function in children and youth with CP, whereas evidence on responsiveness exists only for the FMS and the GMFM dimension E.
C. Ammann-Reiffer, PT, MPTSc, Pediatric Rehab Research Group, Rehabilitation Center for Children and Adolescents, University Children's Hospital Zurich, Affoltern am Albis, Switzerland; Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland; and Department of Epidemiology, Musculoskeletal Research Group CAPHRI, Maastricht University, Maastricht, the Netherlands. Mailing address: Pediatric Rehab Research Group, Rehabilitation Center for Children and Adolescents, University Children's Hospital Zurich, Mühlebergstrasse 104, CH-8910 Affoltern am Albis, Switzerland. corinne.ammann@kispi.uzh.ch.
Corinne
C
Ammann-Reiffer
C.H.G. Bastiaenen, PhD, Department of Epidemiology, Musculoskeletal Research Group CAPHRI, Maastricht University.
Caroline H G
CH
Bastiaenen
R.A. de Bie, PhD, Department of Epidemiology and Institute for Education, Maastricht University, and CAPHRI Research School, Maastricht, the Netherlands.
Rob A
RA
de Bie
H.J.A. van Hedel, PT, PhD, Rehabilitation Center for Children and Adolescents, University Children's Hospital Zurich, and Children's Research Center, University Children's Hospital Zurich.
Hubertus J A
HJ
van Hedel
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004185:Disability Evaluation; D020233:Gait Disorders, Neurologic / Q000503:physiopathology* / Q000534:rehabilitation; D006801:Humans; D007223:Infant; D009468:Neuromuscular Diseases / Q000503:physiopathology* / Q000534:rehabilitation; D015203:Reproducibility of Results