title: Reliability and validity of the Upper Limb Physician's Rating Scale in children with cerebral palsy.
abstract: OBJECTIVE
  The Upper Limb Physician's Rating Scale (ULPRS) is a tool that assesses movement quality of the upper limbs. It is used as an outcome measure after botulinum toxin type A injection in children with cerebral palsy (CP). This study aimed to investigate the reliability and validity of the ULPRS in children with spastic CP.
  
  
  METHODS
  Thirty children with spastic CP (M:F=17:13) aged 5 to 13 years old were recruited. The ULPRS was scored based on recorded videotapes by four physicians on two separate occasions. The Melbourne Assessment of Unilateral Upper Limb Function (MUUL) was scored by an occupational therapist. Intraclass correlation coefficients (ICCs), 95% confidence intervals and weighted kappa statistics were calculated for the scores of ULPRS to obtain interrater and intrarater reliability. The relationship between ULPRS and MUUL was assessed using Pearson correlation coefficients.
  
  
  RESULTS
  The ICCs for the total ULPRS scores were 0.94 between raters and 0.99 to 1.00 within raters. The weighted kappa statistics for subitem scores for the ULPRS ranged from 0.67 to 1.00 within raters and from 0.46 to 0.86 between raters. The relationship between ULPRS and MUUL was strong (Pearson correlation coefficient=0.751; p<0.05).
  
  
  CONCLUSIONS
  The results demonstrated the high reliability of the total ULPRS score within and between raters. A significant concurrent validity between ULPRS and MUUL also supports the clinical utility of the ULPRS as an outcome measure of spastic upper limb in children with CP.
authors.affiliation: Department of Rehabilitation Medicine, Severance Hospital, Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Eun Sook
authors.initials: ES
authors.lastname: Park
authors.affiliation: Department of Rehabilitation Medicine, Severance Hospital, Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Ji-Woon
authors.initials: JW
authors.lastname: Joo
authors.affiliation: Department of Rehabilitation Medicine, Severance Hospital, Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Seon Ah
authors.initials: SA
authors.lastname: Kim
authors.affiliation: Department of Rehabilitation Medicine, Severance Hospital, Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Dong-Wook
authors.initials: DW
authors.lastname: Rha
authors.affiliation: Department of Rehabilitation Medicine, Severance Hospital, Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Korea. werch@yuhs.ac.
authors.forename: Soo Jin
authors.initials: SJ
authors.lastname: Jung
mesh_terms: D000293:Adolescent; D001132:Arm / Q000503:physiopathology*; D002547:Cerebral Palsy / Q000503:physiopathology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D010820:Physicians; D015203:Reproducibility of Results
keywords: Melbourne assessment; Upper extremity; botulinum toxin type A injection; outcome measure; unilateral upper limb function