Instruments for the evaluation of motor abilities for children with severe multiple disabilities: A systematic review of the literature.
LE85, MFM, and WeeFIM are the strongest tools we have for tracking motor skills in kids with severe multiple disabilities, but check reliability yourself before trusting the numbers.
01Research in Context
What this study did
The authors hunted for every paper that tested motor tools on kids with severe multiple disabilities.
They kept only studies that reported how valid, reliable, or responsive the tools were.
In the end they compared nine tests head-to-head.
What they found
LE85 and MFM came out on top for measuring what they claim to measure.
WeeFIM showed it can spot change over time.
Reliability studies were thin and weak, so we still don’t know if scores stay steady day to day.
How this fits with other research
Wouters et al. (2017) later showed that plain fitness tests like the 6-minute walk are both doable and repeatable for kids with moderate–severe ID. Their good reliability scores make the weak reliability in Perez et al. (2015) look even shakier.
Hattier et al. (2011) tested two spasticity scales in the same population. They found the Modified Ashworth Scale is reliable enough to trust, while the Modified Tardieu Scale is not. Together with Perez et al. (2015), the pattern is clear: some tools work, others need fixes.
Houwen et al. (2014) reviewed motor interventions and proved the treatments work. Perez et al. (2015) now tells us which yardsticks to use when we measure that progress.
Why it matters
You now have a short approved list: LE85, MFM, and WeeFIM. Pick one instead of hunting through catalogs. Push your team to run reliability checks before betting big goals on any score.
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02At a glance
03Original abstract
Based on a systematic review, psychometric characteristics of currently available instruments on motor abilities of children with disabilities were evaluated, with the aim to identify candidates for use in children with severe multiple (intellectual and motor) disabilities. In addition, motor abilities are essential for independent functioning, but are severely compromised in these children. The methodological quality of all studies was evaluated with the Consensus Based Standards for the Selection of Health Status Measurement Instruments (COSMIN) Checklist; overall levels of evidence per instrument were based on the Cochrane Back Review Group strategy. As a result, 18 studies with a total of eight instruments, developed for children with cerebral palsy (CLA, GMFM-88 and LE85), spinal muscular atrophy (MHFMS), neuromuscular diseases (MFM), disabilities 0-6 years (VAB, WeeFIM), and one developed specifically for children with severe multiple disabilities (TDMMT) were found. Strong levels of evidence were found for construct validity of LE85 and MFM and for responsiveness of WeeFIM, but reliability studies of these instruments had a limited methodological quality. Up to now studies of the TDMMT resulted in limited and unknown evidence for structural validity due to the poor methodological quality of reliability studies. In a next step, the clinical suitability of the instruments for children with severe multiple disabilities will be evaluate.
Research in developmental disabilities, 2015 · doi:10.1016/j.ridd.2015.09.002