Inter-rater reliability of activity questionnaires after an intensive motor-skill learning intervention for children with cerebral palsy (CP)

Publication date: Available online 18 February 2019

Source: Archives of Physical Medicine and Rehabilitation

Author(s): Julie Paradis, Delphine Dispa, Agnès De Montpellier, Daniela Ebner, Rodrigo Araneda, Geoffroy Saussez, Anne Renders, Carlyne Arnould, Yannick Bleyenheuft

Abstract

Objective

To investigate the reliability of parents-reported activity questionnaires after a motor-skill learning intervention for children with cerebral palsy (CP). We hypothesize that the intervention process might influence parental judgment.

Design

Double-blind randomized trial.

Setting

Conventional therapy was delivered in the usual context while intensive intervention was provided at the Université Catholique de Louvain.

Participants

41 children with CP (age 5-18, GMFCS I-IV) were randomized to a control group (CG, n=21, 2 drop-outs) receiving conventional therapy or an intervention group (IG, n=20) receiving HABIT-ILE.

Interventions

Conventional therapy (mostly neurodevelopmental) was delivered as ongoing treatment (1-5 times/week). HABIT-ILE, based on motor-skill learning, was delivered over 2-weeks. All children were assessed at T1 (baseline), T2 (3 weeks after baseline) and T3 (4 months after baseline).

Main outcomes Measure(s): ABILHAND-Kids and ACTIVLIM-CP questionnaires rated by parents (perception) and two examiners (videotapes).

Results

Agreement (level/range) between examiners was systematically almost perfect (p≤0.001). At baseline, moderate to almost perfect agreement (level/range) were observed between parents and examiners (p≤0.001). At T2 and T3, a similar agreement (level/range) was observed for the CG. For the IG, a similar level of agreement was observed but the range of agreement varied from poor to almost perfect (p≤0.001), with parents estimating higher performance measures compared to examiners after intervention. Higher performance was associated with higher satisfaction scores of the child's functional goals at T3.

Conclusion

Parents and examiners have a similar perception of the child's performance at baseline and during conventional therapy. Their perceptions are less congruent after a motor-skill learning intervention, probably due to the goal-oriented process of the intervention. Therefore, our results favor the use of blind observations of home-videotaped items after intensive motor-skill learning interventions.

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