Psychometric properties of gross motor assessment tools for children: a systematic review

Abstract

ObjectiveGross motor assessment tools have a critical role in identifying, diagnosing and evaluating motor difficulties in childhood. The objective of this review was to systematically evaluate the psychometric properties and clinical utility of gross motor assessment tools for children aged 2–12 years.MethodA systematic search of MEDLINE, Embase, CINAHL and AMED was performed between May and July 2017. Methodological quality was assessed with the COnsensus-based Standards for the selection of health status Measurement INstruments checklist and an outcome measures rating form was used to evaluate reliability, validity and clinical utility of assessment tools.ResultsSeven assessment tools from 37 studies/manuals met the inclusion criteria: Bayley Scale of Infant and Toddler Development-III (Bayley-III), Bruininks-Oseretsky Test of Motor Proficiency-2 (BOT-2), Movement Assessment Battery for Children-2 (MABC-2), McCarron Assessment of Neuromuscular Development (MAND), Neurological Sensory Motor Developmental Assessment (NSMDA), Peabody Developmental Motor Scales-2 (PDMS-2) and Test of Gross Motor Development-2 (TGMD-2). Methodological quality varied from poor to excellent. Validity and internal consistency varied from fair to excellent (α=0.5–0.99). The Bayley-III, NSMDA and MABC-2 have evidence of predictive validity. Test–retest reliability is excellent in the BOT-2 (intraclass correlation coefficient (ICC)=0.80–0.99), PDMS-2 (ICC=0.97), MABC-2 (ICC=0.83–0.96) and TGMD-2 (ICC=0.81–0.92). TGMD-2 has the highest inter-rater (ICC=0.88–0.93) and intrarater reliability (ICC=0.92–0.99).ConclusionsThe majority of gross motor assessments for children have good-excellent validity. Test–retest reliability is highest in the BOT-2, MABC-2, PDMS-2 and TGMD-2. The Bayley-III has the best predictive validity at 2 years of age for later motor outcome. None of the assessment tools demonstrate good evaluative validity. Further research on evaluative gross motor assessment tools are urgently needed.

Pediatric Sarcopenia: A Paradigm in the Overall Definition of Malnutrition in Children?

“…Reduced muscle function may be directly impacted by delays in fine motor, gross motor, and cognitive development in early childhood or vice versa, especially in children with chronic diseases . There is currently no gold standard tool to assess motor function impairment in children being assessed for sarcopenia . It is challenging to assess muscle function in a standardized way with infants, as their motor performance is determined by a variety of factors, including the development of postural control, coordination, core stability, and ability to perform purposeful and isolated movements.…”

“…For example, the Alberta Infant Motor Scales (0–18 months) include evaluation criteria related to antigravity movement, and the Peabody Developmental Motor Scales, Second Edition (birth–5 years) and Bruininks‐Oseretsky Test of Motor Proficiency, Second Edition (4–21 years) include items related to strength and consider the relative developmental age and stage of gross motor and fine motor development . A variety of other assessment tools are used clinically to assess infant and child motor development; however, many do not address muscle strength or assessment of muscle strength may be limited to just a few items of a tool more comprehensive than may be desired for sarcopenia assessment and classification . These tools involve scoring by examiners, often pediatric physical or occupational therapists who can compare individual child scores with published normative data.…”

“…46,47 There is currently no gold standard tool to assess motor function impairment in children being assessed for sarcopenia. 48 It is challenging to assess muscle function in a standardized way with infants, as their motor performance is determined by a variety of factors, including the development of postural control, coordination, core stability, and ability to perform purposeful and isolated movements. Decreased muscle function may contribute to delays in gross and fine motor performance, but it is challenging to isolate the specific effects of decreased muscle function in infants and young children.…”

“…48,50 A variety of other assessment tools are used clinically to assess infant and child motor development; however, many do not address muscle strength or assessment of muscle strength may be limited to just a few items of a tool more comprehensive than may be desired for sarcopenia assessment and classification. 48 These tools involve scoring by examiners, often pediatric physical or occupational therapists who can compare individual child scores with published normative data. Within the emerging sarcopenia literature in children, motor function assessments have not yet been applied to the evaluation of sarcopenia in early childhood.…”

Sarcopenia in Chronic Liver Disease: Impact on Outcomes

“…In younger children (<3 years), considerations of gross and fine motor skills to assess muscle function/strength are warranted. Tools used include the validated Alberta Infant Motor Scale and the Peabody Developmental Motor Scale (grade B‐C) . Sarcopenia assessment in children should also include a comprehensive evaluation of growth, as significant differences in growth ( z scores <–1.5) in children with sarcopenia were observed (grade C‐D) …”