Reliability and Validity of the Upper Limb Physician's Rating Scale in Children with Cerebral Palsy

Abstract

PurposeThe Upper Limb Physician's Rating Scale (ULPRS) is a tool that assesses movement quality of the upper limbs. It is used as an outcome measure after botulinum toxin type A injection in children with cerebral palsy (CP). This study aimed to investigate the reliability and validity of the ULPRS in children with spastic CP.Materials and MethodsThirty children with spastic CP (M:F=17:13) aged 5 to 13 years old were recruited. The ULPRS was scored based on recorded videotapes by four physicians on two separate occasions. The Melbourne Assessment of Unilateral Upper Limb Function (MUUL) was scored by an occupational therapist. Intraclass correlation coefficients (ICCs), 95% confidence intervals and weighted kappa statistics were calculated for the scores of ULPRS to obtain interrater and intrarater reliability. The relationship between ULPRS and MUUL was assessed using Pearson correlation coefficients.ResultsThe ICCs for the total ULPRS scores were 0.94 between raters and 0.99 to 1.00 within raters. The weighted kappa statistics for subitem scores for the ULPRS ranged from 0.67 to 1.00 within raters and from 0.46 to 0.86 between raters. The relationship between ULPRS and MUUL was strong (Pearson correlation coefficient=0.751; p<0.05).ConclusionThe results demonstrated the high reliability of the total ULPRS score within and between raters. A significant concurrent validity between ULPRS and MUUL also supports the clinical utility of the ULPRS as an outcome measure of spastic upper limb in children with CP.

Virtual reality rehabilitation in children with brain injury: a randomized controlled trial

“…The Upper Limb Physician’s Rating Scale (ULPRS) is a semi‐quantitative assessment designed to assess movement patterns, focusing on all three regions of the arm, including the palm, forearm, and elbow 16 . The ULPRS is a reliable and valid measure of quality of upper‐limb movement in children with CP 16 . It determines whether there is an isolated functional impairment, such as restricted forearm supination, wrist in flexion and deviation, elbow flexed, or thumb‐in‐palm.…”

“…16 The ULPRS is a reliable and valid measure of quality of upper-limb movement in children with CP. 16 It determines whether there is an isolated functional impairment, such as restricted forearm supination, wrist in flexion and deviation, elbow flexed, or thumb-in-palm. A total score for unilateral limbs ranging from 0 to 25 was used for the analysis.…”

Relationship between the more-affected upper limb function and daily activity performance in children with cerebral palsy: a cross-sectional study

“…The ULPRS is a semiquantitative assessment that evaluates movement patterns and determines functional impairment of the upper limb by focusing on all three arm levels, including the palm, forearm, and elbow (Supplemental Table S1) [18]. The advantages of the ULPRS include its ease of use by healthcare providers without the need for special training, and high inter-rater and intra-rater reliability (ICC = 0.94 between raters, and ICC = 0.99-1.00 within raters) [19]. Among other parameters, the ULPRS assessment can determine whether there is an isolated functional impairment, such as restricted forearm supination, a wrist in flexion and deviation, elbow flexion, or thumb-in-palm, with unilateral limb scores ranging from 0 to 25 (lower scores represent worse impairment).…”

Serebral palsili çocuklarda rehabilitasyon planı ve takım yaklaşımı

“…Bunları kısaca gözden geçirecek olursak; kaba motor fonksiyon ölçeği (GMFM), yürüme fonksiyonlarının değerlendirilmesi için kullanılan, Edinburgh Gözlemsel Yürüme Skoru, Modified Physician Rating Scale (PRS), Rivermead Gözlemsel Yürüme Analizi Formu, üst ekstremite değerlendirme araçlarından; Abilhand-Kids Anketi, Çocukların El Kullanım Deneyim Anketi (CHEQ 2.0 Versiyon), ACTIVLIM-Etkinlik Kısıtlama Anketi, Upper Extremity Physician's Rating Scale, Üst Ekstremite Beceri Kalitesi (QUEST), günlük yaşam aktivitelerini değerlendiren araçlardan; Fonksiyonel Bağımsızlık Ölçütü (Wee FIM), Pediatrik özürlülük değerlendirme envanteri (PEDI), yaşam kalitesini değerlendiren araçlardan; Quality of Life Questionnaire for Children (CP QOL-Child, Pediatric Quality of Life Inventory (PedsQL; Çocukluk Çağı Sağlık Değerlendirme Anketi (CHAQ) sayılabilir. [19][20][21][22][23][24] SP riski taşıyan bebeklerde, özellikle yaşamın ilk bir yılında; gelişimsel sorunların erken saptanması, yaşamın ilk yılı boyunca erken müdahale, destek terapiler ve rehabilitasyon yaklaşımları için çok önemlidir. Erken dönemde riskli bebeklerin desteklenmesi ve uygun hizmet verilmesi için erken teşhis ve sınıflandırılma önemlidir.…”