Reliability and validity of short‐term performance tests for wheelchair‐using children and adolescents with cerebral palsy

Abstract

AIM To investigate the test-retest reproducibility of the Muscle Power Sprint Test (MPST), the 10 9 5-m sprint test, and the arm-cranking Wingate Anaerobic Test (WAnT) in children and adolescents with cerebral palsy (CP). A secondary objective was to assess the construct validity of the MPST.METHOD Twenty-three participants with spastic CP (mean age 13y 3mo, range 7-18y, SD 3.6y; 18 males, five females, two classified as having spastic unilateral CP, 21 as having spastic bilateral CP) using a manual wheelchair for at least part of the day were recruited and tested in different rehabilitation settings in the Netherlands. Participants were classified as in Gross Motor Function Classification System Expanded and Revised (GMFCS-E&R) levels III and IV. INTERPRETATION The MPST, the 10 9 5-m sprint test, and the arm-cranking WAnT are reproducible tests for measuring anaerobic performance and agility in adolescents with spastic CP who self-propel a manual wheelchair. The MPST has been shown to be a valid test to measure anaerobic performance in this population.Anaerobic performance and agility are important physiological factors that play a critical role in the ability of a child or adolescent with cerebral palsy (CP) to participate in daily activities.1 This is especially true for children with CP who use a wheelchair for mobility, because most motor activities of daily living (ADL), including playing in the playground, moving around in the classroom, but also climbing a curb and ascending a ramp, are of short duration.2 These short bouts of activity rely primarily on the energy produced by the ATP-PCr (or alactic) component of the anaerobic system and produce a relatively high physical stress on the individual.Exercise testing over time can provide a quantitative assessment of the improvement or decline in the anaerobic performance of children and adolescents with CP and has the potential to be an important measurement tool in clinical practice as well as in research. For children with CP who are able to walk or run independently, running-based field tests, like the Muscle Power Sprint Test (MPST) and the 10 9 5-m sprint test, are currently used in clinical practice and are inexpensive measures that do not require special equipment or training. 3 The MPST has been developed with the specific goal of examining anaerobic performance, 3 while the 10 9 5-m sprint test is a marker of agility.3 These tests, however, have not yet been examined in children and adolescents with CP who use wheelchairs.Anaerobic performance in children with neuromuscular disorders such as CP is often assessed in the laboratory setting using the cycling Wingate Anaerobic Test (WAnT). 4 While much of the focus to date has revolved around lower-limb-based anaerobic performance in children with CP, the upper-body or arm-cranking WAnT has been used to predict functional anaerobic performance.5 Tirosh et al. 6 reported that the arm-cranking WAnT was both feasible and reliable in a group of children with CP. This study, conducted over two decades ago, ...

Correlación de las destrezas manuales y la función motriz gruesa con la capacidad para propulsar una silla de ruedas en niños con parálisis cerebral

“…Todos los pacientes tenían una PC espástica de distribución bilateral. La mediana de la edad fue de 10 años (rango intercuartil [8][9][10][11][12][13][14][15] La Figura 2 muestra la correlación entre la prueba de caja y cubos y la prueba de los 6 minutos. Se encontró una correlación estadísticamente significativa (p=0,004; r=0,48).…”

“…La calidad de la silla y las características de su diseño no se tuvieron en cuenta y estas variables pueden tener influencia en el resultado1. Llama la atención que la distancia lograda en la prueba del impulso fue inferior a la reportada en otras investigaciones 10 . Para evaluar los rendimientos y progresos del paciente en la silla de ruedas, no se recomiendan sillas de diseño estándar sino las formuladas y adaptadas para cada paciente 11 .…”

“…Las distancias recorridas en la prueba por niños en estado funcional III son cercanas a las reportadas por otros autores 10 . Sin embargo, en el caso de los niños en estado funcional IV las distancias observadas en nuestros pacientes fueron mucho menores.…”

“…Los participantes se instruyeron para desplazarse en su silla de ruedas lo más rápido posible a lo largo de un corredor lineal de 20 metros con marcas en el piso cada dos metros y luego regresar 9 . Se siguieron las recomendaciones adaptadas para la prueba en silla de ruedas 10 . A los niños se les instruyó para que repitieran este ciclo tantas veces como fuera posible durante 6 minutos.…”

The Muscle Power Sprint Test

“…1,2 It takes a few minutes to complete and only requires an open space, a stopwatch and two cones. The Muscle Power Sprint Test is similar to the 'gold standard' Wingate Anaerobic Test in that it provides measurements of anaerobic power.…”