Psychometric and Clinimetric Properties of the Melbourne Assessment 2 in Children with Cerebral Palsy

Publication date: Available online 28 February 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Tien-Ni Wang, Kai-Jie Liang, Yi-Chia Liu, Jeng-Yi Shieh, Hao-Ling Chen
ObjectiveThe Melbourne Assessment 2 (MA2) is increasingly used as an outcome measurement in clinical studies. The purposes of this study were to examine its psychometric and clinimetric properties.DesignPsychometric and clinimetric study.SettingCommunity.ParticipantsSeventeen children with CP from 5 to 12 years were recruited for the estimation of the test-retest reliability and minimal detectable change (MDC). Thirty-five children with CP were recruited to receive an eight-week intensive neurorehabilitation intervention to estimate the validity, responsiveness, and minimal clinically important difference (MCID).InterventionsThirty-five children with CP received upper limb neurorehabilitation programs for eight weeks.Main Outcome MeasuresThe Melbourne Assessment 2 (MA2) and the criterion measures, including the Bruininks-Oseretsky Test of Motor Proficiency 2^nd (BOT-2), the Box and Blocks Test (BBT), and the Pediatric Motor Activity Log-Revised (PMAL-R) were evaluated at pretreatment and posttreatment.ResultsThe MA2 has four subscales: range of motion, fluency, accuracy, and dexterity. The test-retest reliability of the MA2 is high (ICC=0.92-0.98). The significant relationships between the MA2 and BBT, BOT-2, and PMAL-R support its validity. The significance of paired t test results (p<0.001) and large magnitudes of the SRM (1.70-2.00) confirm the responsiveness of the MA2. The MDC values of the four subscales of the MA2 are 2.85, 1.63, 1.97, and 1.84, respectively, and the suggested MCID values of these four subscales are 2.35, 3.20, 2.09, and 2.22, respectively, indicating the minimum scores of improvement to be interpreted as both statistically significant and clinically important.ConclusionsThe findings of this study indicate that the MA2 has sound psychometric and clinimetric properties and is thus an adequate measurement for research and clinical applications.



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