title: Computerized Adaptive Tests Detect Change Following Orthopaedic Surgery in Youth with Cerebral Palsy.
abstract: BACKGROUND
  The Cerebral Palsy Computerized Adaptive Test (CP-CAT) is a parent-reported outcomes instrument for measuring lower and upper-extremity function, activity, and global health across impairment levels and a broad age range of children with cerebral palsy (CP). This study was performed to examine whether the Lower Extremity/Mobility (LE) CP-CAT detects change in mobility following orthopaedic surgery in children with CP.
  
  
  METHODS
  This multicenter, longitudinal study involved administration of the LE CP-CAT, the Pediatric Outcomes Data Collection Instrument (PODCI) Transfer/Mobility and Sports/Physical Functioning domains, and the Timed "Up & Go" test (TUG) before and after elective orthopaedic surgery in a convenience sample of 255 children, four to twenty years of age, who had CP and a Gross Motor Function Classification System (GMFCS) level of I, II, or III. Standardized response means (SRMs) and 95% confidence intervals (CIs) were calculated for all measures at six, twelve, and twenty-four months following surgery.
  
  
  RESULTS
  SRM estimates for the LE CP-CAT were significantly greater than the SRM estimates for the PODCI Transfer/Mobility domain at twelve months, the PODCI Sports/Physical Functioning domain at twelve months, and the TUG at twelve and twenty-four months. When the results for the children at GMFCS levels I, II, and III were grouped together, the improvements in function detected by the LE CP-CAT at twelve and twenty-four months were found to be greater than the changes detected by the PODCI Transfer/Mobility and Sports/Physical Functioning scales. The LE CP-CAT outperformed the PODCI scales for GMFCS levels I and III at both of these follow-up intervals; none of the scales performed well for patients with GMFCS level II.
  
  
  CONCLUSIONS
  The results of this study showed that the LE CP-CAT displayed superior sensitivity to change than the PODCI and TUG scales after musculoskeletal surgery in children with CP.
authors.affiliation: Department of Occupational Therapy, School of Health Professions, Thomas Jefferson University, 901 Walnut Street, Philadelphia, PA 19107. E-mail address: maryjane.mulcahey@jefferson.edu.
authors.forename: M J
authors.initials: MJ
authors.lastname: Mulcahey
authors.affiliation: Health and Disability Research Institute, School of Public Health, Boston University, 715 Albany Street, Boston, MA 02118.
authors.forename: Mary D
authors.initials: MD
authors.lastname: Slavin
authors.affiliation: Health and Disability Research Institute, School of Public Health, Boston University, 715 Albany Street, Boston, MA 02118.
authors.forename: Pengsheng
authors.initials: P
authors.lastname: Ni
authors.affiliation: Shriners Hospitals for Children, 2211 North Oak Park Avenue, Chicago, IL 60707.
authors.forename: Lawrence C
authors.initials: LC
authors.lastname: Vogel
authors.affiliation: Shriners Hospitals for Children, 3551 North Broad Street, Philadelphia, PA 19438.
authors.forename: Scott H
authors.initials: SH
authors.lastname: Kozin
authors.affiliation: Deceased.
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Haley
authors.affiliation: Health and Disability Research Institute, School of Public Health, Boston University, 715 Albany Street, Boston, MA 02118.
authors.forename: Alan M
authors.initials: AM
authors.lastname: Jette
mesh_terms: D000222:Adaptation, Physiological; D000223:Adaptation, Psychological; D000293:Adolescent; D000704:Analysis of Variance; D002547:Cerebral Palsy / Q000175:diagnosis / Q000523:psychology* / Q000601:surgery*; D002648:Child; D015331:Cohort Studies; D016001:Confidence Intervals; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D020233:Gait Disorders, Neurologic / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008137:Longitudinal Studies; D035002:Lower Extremity / Q000601:surgery; D008297:Male; D053580:Muscle Strength / Q000502:physiology; D019637:Orthopedic Procedures / Q000379:methods*; D011594:Psychometrics; D011788:Quality of Life; D016059:Range of Motion, Articular; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D016138:Walking / Q000502:physiology