title: Construct validity and reliability of the Selective Control Assessment of the Lower Extremity in children with cerebral palsy.
abstract: OBJECTIVE
  Assessing impaired selective voluntary movement control in children with cerebral palsy (CP) has gained increasing interest. We investigated construct validity and intra- and interrater reliability of the Selective Control Assessment of the Lower Extremity (SCALE).
  
  
  METHODS
  Thirty-nine children (21 males, 18 females) with spastic CP, mean age 12 years 6 months [range 6y 11mo-19y 9mo], Gross Motor Function Classification System (GMFCS) levels I to IV, participated. Differences in SCALE scores were determined on joint levels and between patients categorized according to their limb distribution and GMFCS levels. SCALE scores were correlated with the Fugl-Meyer Assessment, Manual Muscle Test, and Modified Ashworth Scale. To determine reliability, the SCALE was applied once and recorded on video.
  
  
  RESULTS
  SCALE scores differed significantly between the less and more affected leg (p<0.001) and between most leg joints. Total SCALE scores differed significantly between GMFCS levels I and II. Correlations with Fugl-Meyer Assessment, Manual Muscle Test, and Modified Ashworth Scale were 0.88, 0.88, and -0.55 respectively. Intraclass correlation coefficients were all above 0.9, with the minimal detectable change below 2 points.
  
  
  CONCLUSIONS
  The SCALE appears to be a valid and reliable tool to assess selective voluntary movement control of the legs in children with spastic CP.
authors.affiliation: Pediatric Rehab Research Group, Rehabilitation Center for Children and Adolescents, University Children's Hospital Zurich, Affoltern am Albis, Switzerland.
authors.forename: Julia
authors.initials: J
authors.lastname: Balzer
authors.affiliation: Pediatric Rehab Research Group, Rehabilitation Center for Children and Adolescents, University Children's Hospital Zurich, Affoltern am Albis, Switzerland.
authors.forename: Petra
authors.initials: P
authors.lastname: Marsico
authors.affiliation: Regional Group Zurich Foundation Cerebral Palsy (RGZ), Zurich, Switzerland.
authors.forename: Elena
authors.initials: E
authors.lastname: Mitteregger
authors.affiliation: Rehabilitation Sciences, School of Health Sciences, Queen Margaret University, Edinburgh, UK.
authors.forename: Marietta L
authors.initials: ML
authors.lastname: van der Linden
authors.affiliation: Rehabilitation Sciences, School of Health Sciences, Queen Margaret University, Edinburgh, UK.
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Mercer
authors.affiliation: Pediatric Rehab Research Group, Rehabilitation Center for Children and Adolescents, University Children's Hospital Zurich, Affoltern am Albis, Switzerland.
authors.forename: Hubertus J A
authors.initials: HJ
authors.lastname: van Hedel
mesh_terms: D000293:Adolescent; D000328:Adult; D002547:Cerebral Palsy / Q000175:diagnosis*; D002648:Child; D005080:Exercise Test / Q000379:methods / Q000592:standards*; D005260:Female; D006801:Humans; D035002:Lower Extremity / Q000503:physiopathology*; D008297:Male; D009128:Muscle Spasticity; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D055815:Young Adult