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Clutterbuck G1,2, Auld M1,2, Johnston L1
1University of Queensland, School of Health and Rehabilitation Sciences, St Lucia, Australia, 2Cerebral Palsy League, Brisbane, Australia
Background: Sports are an important social experience and long-term intervention for children with disabilities, however, children with cerebral palsy (CP) participate less in sport than typically developing peers. Physiotherapy assessment of sports-specific gross motor skills is critical when identifying sporting opportunities. However, common CP-specific assessments demonstrate ceiling effects for ambulant children (e.g. Gross Motor Function Measure) and 'higher-level' assessments frequently employ tasks unrelated to sport. More challenging assessments are available, but psychometric data for children with CP is limited.
Purpose: To investigate:
(1) performance of ambulant children with CP on sports-focussed gross motor assessments;
(2) concurrent validity of mainstream sports-focussed fundamental movement skills assessment, the Test of Gross Motor Development-2 (TGMD-2), with the CP-specific Gross Motor Function Measure-Challenge (GMFM-Challenge), and
(3) concurrent validity between these assessments and performance on running, jumping and throwing field tests.
Methods: Participants were 54 children (35 male) aged 6-12 years (8.8±2.03 years), with ambulant CP (GMFCS I=17, II=37). Children participated in one 120-minute sport-focussed gross motor assessment session, including: the TGMD-2 (generating total, locomotor and object control scores and percentile ranks); the GMFM-Challenge (total score including locomotor and object control items) and sports field tests for running (Muscle Power Sprint Test (MPST) and 10x5m Shuttle Run Test (10x5mSRT)), jumping (Vertical Jump and Broad Jump) and throwing (Seated Throw). Data was examined with SPSS using non-parametric analyses. Performance on each measure was examined using medians and interquartile ranges. Possible associations between measures were examined using Spearman's correlations.
Results: All children with CP, GMFCS-I/II, in this study could attempt all TGMD-2, GMFM-Challenge items and field tests. Discriminative ability was good for both batteries. Children achieved TGMD-2 percentile ranks of 1 to 92% for overall performance, 1 to 95% for locomotion and 1 to 95% for object control. GMFM-Challenge scores ranged from 2.3 to 81.3 of a possible 112. Children at GMFCS I demonstrated higher scores on all locomotor assessments than children at GMFCS II (p 0.001). Children with higher TGMD-2-Total scores also achieved higher GMFM-Challenge scores (r(52)=0.729, p 0.001). Children with higher TGMD-2-Total, TGMD-2-Locomotor, and GMFM-Challenge scores also demonstrated higher scores in field tests involving running (MPST and 10x5mSRT: r(52)=-0.535 to -0.816, p 0.001) and jumping (Vertical Jump and Broad Jump: r(52)0.499 to 0.774, p 0.001). Seated Throw was not strongly correlated with any other assessment item.
Conclusion(s): All ambulant children with CP could attempt all sports-focussed gross motor assessments studied. Performance ranged from 1 to 95% showing a good ability to discriminate performance. Performance was strongly associated with GMFCS level. Concurrent validity of the TGMD-2 was established with the GMFM-Challenge and locomotor gross motor field tests.
Implications: Physiotherapists should assess sports-related gross motor function for ambulant children with CP to guide sports participation options. The GMFM-Challenge and TGMD-2 are valuable in assessing a range of sport-focussed skills. Due to their specificity, running, jumping and throwing field tests are best positioned to monitor change, or assess higher-level sport potential, particularly in sports closely related to the assessment. Further research could evaluate relationships between clinical assessment and on-field sports performance.
Keywords: Disability, Sport, Assessment
Funding acknowledgements: Queensland Government, Gambling Community Benefit Fund.
Purpose: To investigate:
(1) performance of ambulant children with CP on sports-focussed gross motor assessments;
(2) concurrent validity of mainstream sports-focussed fundamental movement skills assessment, the Test of Gross Motor Development-2 (TGMD-2), with the CP-specific Gross Motor Function Measure-Challenge (GMFM-Challenge), and
(3) concurrent validity between these assessments and performance on running, jumping and throwing field tests.
Methods: Participants were 54 children (35 male) aged 6-12 years (8.8±2.03 years), with ambulant CP (GMFCS I=17, II=37). Children participated in one 120-minute sport-focussed gross motor assessment session, including: the TGMD-2 (generating total, locomotor and object control scores and percentile ranks); the GMFM-Challenge (total score including locomotor and object control items) and sports field tests for running (Muscle Power Sprint Test (MPST) and 10x5m Shuttle Run Test (10x5mSRT)), jumping (Vertical Jump and Broad Jump) and throwing (Seated Throw). Data was examined with SPSS using non-parametric analyses. Performance on each measure was examined using medians and interquartile ranges. Possible associations between measures were examined using Spearman's correlations.
Results: All children with CP, GMFCS-I/II, in this study could attempt all TGMD-2, GMFM-Challenge items and field tests. Discriminative ability was good for both batteries. Children achieved TGMD-2 percentile ranks of 1 to 92% for overall performance, 1 to 95% for locomotion and 1 to 95% for object control. GMFM-Challenge scores ranged from 2.3 to 81.3 of a possible 112. Children at GMFCS I demonstrated higher scores on all locomotor assessments than children at GMFCS II (p 0.001). Children with higher TGMD-2-Total scores also achieved higher GMFM-Challenge scores (r(52)=0.729, p 0.001). Children with higher TGMD-2-Total, TGMD-2-Locomotor, and GMFM-Challenge scores also demonstrated higher scores in field tests involving running (MPST and 10x5mSRT: r(52)=-0.535 to -0.816, p 0.001) and jumping (Vertical Jump and Broad Jump: r(52)0.499 to 0.774, p 0.001). Seated Throw was not strongly correlated with any other assessment item.
Conclusion(s): All ambulant children with CP could attempt all sports-focussed gross motor assessments studied. Performance ranged from 1 to 95% showing a good ability to discriminate performance. Performance was strongly associated with GMFCS level. Concurrent validity of the TGMD-2 was established with the GMFM-Challenge and locomotor gross motor field tests.
Implications: Physiotherapists should assess sports-related gross motor function for ambulant children with CP to guide sports participation options. The GMFM-Challenge and TGMD-2 are valuable in assessing a range of sport-focussed skills. Due to their specificity, running, jumping and throwing field tests are best positioned to monitor change, or assess higher-level sport potential, particularly in sports closely related to the assessment. Further research could evaluate relationships between clinical assessment and on-field sports performance.
Keywords: Disability, Sport, Assessment
Funding acknowledgements: Queensland Government, Gambling Community Benefit Fund.
Topic: Paediatrics; Disability & rehabilitation; Outcome measurement
Ethics approval required: Yes
Institution: Cerebral Palsy League of Queensland
Ethics committee: Cerebral Palsy League of Queensland
Ethics number: CPL-2016-004
All authors, affiliations and abstracts have been published as submitted.
