A systematic review of the clinimetric properties of measures of habitual physical activity in primary school aged children with cerebral palsy.
No single tool is psychometrically sound for measuring habitual physical activity in children with CP—accelerometers are valid but need reliability testing.
01Research in Context
What this study did
The team looked at every study that tested how well we can measure daily movement in kids with cerebral palsy.
They only picked papers about children years.
They asked: does the tool really catch how much the child moves every day, and does it give the same answer twice?
What they found
No single tool passed every test.
Accelerometers (the small boxes kids wear on their hip) came closest.
They track movement well, but we still do not know if they give the same score on two different days.
How this fits with other research
Keawutan et al. (2014) used the same kind of review one year later.
They did not ask if the tools work; they asked if better motor skills mean more daily movement.
Their answer was yes — kids who walk better move more.
So Robertson et al. (2013) tells us which tool to pick, and Keawutan et al. (2014) tells us why the data matter.
Simonian et al. (2020) and Peñuelas-Calvo et al. (2019) also checked tools, but for adults at work and for autism.
They show the same big idea: pick the right yardstick before you measure.
Why it matters
If you track physical activity as an outcome, use an accelerometer but test it twice on the same child. Until we have that reliability data, treat step counts as rough guides, not hard facts.
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02At a glance
03Original abstract
Regular participation in physical activity is an important determinant of health for children and adolescents with cerebral palsy (CP). However, there is little consensus on the most valid or reliable method to measure physical activity in this population. This study aimed to systematically review the psychometric properties of habitual physical activity (HPA) measures in primary school-aged children with CP. Databases were systematically searched for measures assessing physical activity over more than one day and had evidence of validity, reliability and/or clinical utility in children aged 6-12 years with CP. Ten measures met inclusion criteria and their quality was assessed in twelve studies. Quality of the included studies was appraised using the consensus-based standards for the selection of health measurement instruments (COSMIN) checklist. Measures were moderately to strongly correlated to criterion measures, with study quality rated as Fair (+) to Poor (0). Only four measures had evidence of reliability. Accelerometers provide a valid measure of HPA with good clinical utility; however they do not have documented reliability in this population. No one measure appears ideal to record HPA in primary school-age children with CP and further research is necessary to determine the psychometric properties of HPA measurement instruments in this population.
Research in developmental disabilities, 2013 · doi:10.1016/j.ridd.2013.04.013