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European Journal of Physical and Rehabilitation Medicine 2020 June;56(3):272-8

DOI: 10.23736/S1973-9087.20.06079-7


language: English

Movement Disorders - Childhood Rating Scale 4-18 revised in children with dyskinetic cerebral palsy

Roberta BATTINI 1, 2 , Giuseppina SGANDURRA 1, 2, Valentina MENICI 2, Roberta SCALISE 2, Ilaria OLIVIERI 2, Roberta DI PIETRO 2, Simona LUCIBELLO 3, Maria T. GIANNINI 4, Giovanni CIONI 1, 2, MD-CRS Group 

1 Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy; 2 Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Pisa, Italy; 3 Unit of Pediatric Neurology, Department of Woman and Child Health and Public Health, Sacred Heart Catholic University, Rome, Italy; 4 Department of Human Neuroscience, Child Neurology and Psychiatry, Sapienza University, Rome, Italy

BACKGROUND: Movement Disorders - Childhood Rating Scale for age 4-18 (MD-CRS 4-18) is a tool aimed to evaluate movement disorders in developmental age, validated since 2008 and applied in the literature. Psychometric properties, including inter- and intra-reliability and construct validity have been evaluated over time on children and adolescents with different types of movement disorders.
AIM: The aim of the study is to revise the Movement Disorders - Childhood Rating Scale 4-18 (MD-CRS 4-18 R) and evaluate its psychometric properties, compared to previous version of the scale, in dyskinetic cerebral palsy.
DESIGN: This is a measurement-focused study of video recorder sessions.
SETTING: Video session carried out inpatient and outpatient.
POPULATION: This measurement-focused study was carried out on a cohort of 57 participants with DCP (37 males; mean age 9 years and 6 months ±3 years and 8 months) evaluated through video-recorded sessions by experienced scorers using MD-CRS 4-18 and MR-CRS 4-18 R.
METHODS: Inter-rater reliability, intra-rater reliability of MD-CRS 4-18 and MD-CRS 4-18 R were performed.
RESULTS: This study supports the relevant contribution of MD-CRS 4-18 R to identify the severity of movement disorders in dyskinetic cerebral palsy, as indicated by the higher ICC values on Index II compared to previous MD-CRS 4-18 results. Standard Error Measurement (SEM) and Minimally Detectable Difference (MDD) of MD-CRS 4-18 R in DCP were all very low, with SEMs ranging from 0.01 to 0.02 and MDD from 0.03 to 0.06.
CONCLUSIONS: Data obtained with MD-CRS 4-18 R are in accordance with previous scale on individuals with movement disorders due to different etiologies, tested with MD-CRS 4-18.
CLINICAL REHABILITATION IMPACT: MD-CRS 4-18 R is able to verify natural history of the disease and represents a standardized clinical outcome measure in the evaluation and follow-up of children with DCP. Also MD-CRS 4-18 Revised form is a feasible tool, now easier to understand than the previous one, more available for incoming clinical trials.

KEY WORDS: Cerebral palsy; Dyskinesias; Psychometrics; Child

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