Validity and clinimetric properties of the Spinal Alignment and Range of Motion Measure in children with cerebral palsy.

AIM The aim of this study was to assess the validity, responsiveness, and clinimetric properties of the Spinal Alignment and Range of Motion Measure (SAROMM) in children with cerebral palsy (CP). METHOD Sixty-two children with CP (40 males, 22 females) with a median age of 3 years and 11 months (range 1-6y) and their caregivers participated in this study. Among the children, 56 had spastic CP while six had non-spastic CP; 53 had bilateral CP, while nine had unilateral limb involvement. Thirty-three children were classified as Gross Motor Function Classification System (GMFCS) levels I to III and 23 as levels IV or V. Fifty-six children (90%) received regular rehabilitation by means of regular physical or occupational therapy (50% once or twice per week and 40% more than two times per week) and six children (10%) received irregular rehabilitation (less than once a week). Construct validity was determined by assessing the strength of the correlation between the spinal alignment SAROMM (SAROMM-SA), the range of motion SAROMM (SAROMM-ROM), and the total SAROMM (SAROMM-total), and construct measures, including the 66-item Gross Motor Function Measure (GMFM-66) and Functional Independence Measures for Children (WeeFIM), at baseline and at 6-months follow-up. Responsiveness was examined using effect size. Minimal detectable change (MDC) at the 90% confidence level (MDC90) and minimal clinically important difference (MCID) were analysed. RESULTS The SAROMM with the GMFM-66 and WeeFIM had fair to good construct validity. The effect size values of all SAROMM scales were 0.24 to 0.48. The MDC90 values and MCID range were 1.43 and 0.47 to 1.67 for the SAROMM-SA, 3.12 and 3.68 to 4.07 for the SAROMM-ROM, and 3.22 and 4.53 to 4.62 for the SAROMM-total. INTERPRETATION The clinimetric properties of the SAROMM allow clinicians to determine whether a change in SAROMM score represents a clinically meaningful change.