Bimanual Fine Motor Function (BFMF) Classification in Children with Cerebral Palsy: Aspects of Construct and Content Validity.
The Bimanual Fine Motor Function (BFMF) is currently the principal classification of hand function recorded by the Surveillance of Cerebral Palsy in Europe (SCPE) register. The BFMF is used in a number of epidemiological studies, but has not yet been validated.


OBJECTIVE
To examine aspects of construct and content validity of the BFMF.


RESULTS
Construct validity of the BFMF was assessed by comparison with the Manual Ability Classification System (MACS) using register-based data from 539 children born 1999-2003 (304 boys; 4-12 years). The high correlation with the MACS (Spearman's rho = 0.89, CI: 0.86-0.91, p<.001) supports construct validity of the BFMF. The content of the BFMF was appraised through literature review, and by using the ICF-CY as a framework to compare the BFMF and MACS. The items hold, grasp and manipulate were found to be relevant to describe increasingly advanced fine motor abilities in children with CP, but the description of the BFMF does not state whether it is a classification of fine motor capacity or performance.


CONCLUSIONS
Our results suggest that the BFMF may provide complementary information to the MACS regarding fine motor function and actual use of the hands, particularly if used as a classification of fine motor capacity.
a Department of Clinical Services , St. Olavs University Hospital , Trondheim , Norway.|b Department of Laboratory Medicine, Children's and Women's Health, Faculty of Medicine , Norwegian University of Science and Technology , Trondheim , Norway.
Ann-Kristin G
AK
Elvrum
b Department of Laboratory Medicine, Children's and Women's Health, Faculty of Medicine , Norwegian University of Science and Technology , Trondheim , Norway.|c Vestfold Hospital Trust , The Cerebral Palsy Register of Norway , Tønsberg , Norway.
Guro L
GL
Andersen
d Department of Pediatrics, Institute of Clinical Sciences, Queen Silvia Children's Hospital , Sahlgrenska Academy at the University of Gothenburg , Gothenburg , Sweden.
Kate
K
Himmelmann
e Department of Physiotherapy, Institute of Neuroscience and Physiology , Sahlgrenska Academy at the University of Gothenburg , Gothenburg , Sweden.
Eva
E
Beckung
f Department of Women's and Children's Health , Karolinska Institutet , Stockholm , Sweden.
Ann-Marie
AM
Öhrvall
g Regional Centre for Child and Youth Mental Health and Child Welfare, Faculty of Medicine , Norwegian University of Science and Technology , Trondheim , Norway.
Stian
S
Lydersen
b Department of Laboratory Medicine, Children's and Women's Health, Faculty of Medicine , Norwegian University of Science and Technology , Trondheim , Norway.
Torstein
T
Vik
D002547:Cerebral Palsy / Q000145:classification* / Q000503:physiopathology / Q000534:rehabilitation; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004185:Disability Evaluation; D005260:Female; D006225:Hand / Q000503:physiopathology*; D018737:Hand Strength; D006801:Humans; D008297:Male; D009048:Motor Skills / Q000145:classification*; D009664:Norway; D012042:Registries; D012720:Severity of Illness Index; D013548:Sweden; D013647:Task Performance and Analysis
Bimanual fine motor function; cerebral palsy; classification; fine motor; manual ability classification system; validity