Psychometric properties of observational tools for identifying motor difficulties - a systematic review.

BACKGROUND: Early identification of children with motor difficulties, such as developmental coordination disorder (DCD), is essential. At present only a fraction of children with DCD are identified. The purpose of the study was to systematically review the literature from 1994 to 2017 on observational screening tools and to evaluate the validity, reliability and usability of the questionnaires used. METHODS: The review of the literature was conducted to synthesize the data from five electronic databases for children aged 6-12 years. The following databases were searched: Academic search Elite (EBSCO), ERIC (ProQuest), MEDLINE (Ovid), PsycINFO (ProQuest), and SPORTDiscus with Full Text (EBSCO). The studies meeting our inclusion criteria were analyzed to assess the psychometric properties and feasibility of the measures. RESULTS: The literature search retrieved 1907 potentially relevant publications. The final number of studies that met the inclusion criteria of our systematic review was 45. There were 11 questionnaires for parents, teachers and children. None of the questionnaires was valid for population-based screening as the only measurement tool. CONCLUSIONS: There are many challenges in using initial screening tools to identify children with motor difficulties. Nevertheless, many promising questionnaires are being developed that can provide information on functional skills and limitations across a variety of tasks and settings in the daily lives of children with DCD. The review provides much needed information about the current scales used in many clinical, educational and research settings. Implications for assessing psychometric properties of the developed questionnaires and further research are discussed. TRIAL REGISTRATION: PROSPERO, CRD42018087532 .

Reliability and validity of the Finnish version of the motor observation questionnaire for teachers.

OBJECTIVES: Observational screening instruments are often used as an effective, economical first step in the identification of children with Developmental Coordination Disorder (DCD). The aim was to investigate the psychometric properties of the Finnish version of the Motor Observation Questionnaire for Teachers (MOQ-T-FI). METHODS: The psychometric properties were tested using two separate samples (S1: age range 6-12, M 9y 5mo, females 101, males 92; S2: age range 6-9, M 7y 7mo, females 404, males 446). Teachers completed the MOQ-T-FI in both samples, and in sample 2 teachers' ratings were compared to student's performance on the Movement Assessment Battery for Children-Second Edition (MABC-2). Internal consistency was investigated by using Cronbach's alpha, predictive validity by receiver operating characteristic (ROC) analysis, concurrent validity by correlation analysis, and construct validity by factor analysis. RESULTS: The MOQ-T-FI behaves consistently with its original Dutch version. The internal consistency was excellent (α=0.97). The bifactor model, with one general factor and two specific factors, fit the data significantly better than the first-order model. The concurrent validity with the MABC-2 was moderate (r=0.37 p<0.001). Sensitivity was 82.5% and specificity 44.5%, respectively. CONCLUSION: Notwithstanding the low specificity the MOQ-T-FI can be considered as a promising screening tool in the school environment for Finnish children at risk of motor learning problems.

Physical fitness profile of elite athletes with intellectual disability.

UNLABELLED: The aim of this study was to investigate the physical fitness profile of high-performance athletes with intellectual disability (ID) in comparison with able-bodied individuals. METHODS: Participants were 231 male and 82 female athletes. All evaluations were done using the EUROFIT physical fitness test. RESULTS: In comparison with population data, both male and female athletes with ID score better for flexibility and upper body muscle endurance, but have similar or lower values for running speed, speed of limb movement, and strength measures. Compared with age-matched physical education students, male athletes with ID score better for running speed and flexibility, and worse for strength. Female athletes with ID score not different from able-bodied individuals for flexibility, running speed, and upper body muscle endurance, but worse for strength measures. Athletes with ID also have poorer cardio respiratory endurance capacity compared with sportive peers without ID. Furthermore, male athletes have a more differentiated profile depending upon their sports discipline, compared with female athletes. CONCLUSION: It can be concluded that high-performance athletes with ID reach physical fitness levels that are equal to or lower than those of able-bodied sportive counterparts. Further research should investigate the importance of reduced muscle strength to be the limiting factor.

Prediction of maximal heart rate in individuals with mental retardation.

PURPOSE: It is well known that individuals with mental retardation (MR), especially those with Down syndrome (DS), have low maximal heart rates (MHR). We evaluated the ability to predict MHR in individuals with MR and DS in comparison with persons without MR. METHODS: Subjects completed a maximal exercise test on the treadmill with metabolic and HR measurements. Stepwise multiple regression was used to develop prediction equations for subjects with MR (N = 276; 97 with DS) and without (N = 296) MR, ranging in age from 9-46 yr. RESULTS: Subjects with MR exhibited significantly lower MHR (177 vs 185 beats.min(-1)) and VO2peak (33.8 vs 35.6 mL.kg-1.min(-1)). In subjects with MR, age was a poor predictor of MHR, Y = 189 - 0.59 (age) (R = 0.30, SEE = 13.8 beats.min-1; P < 0.01), but age was a better predictor for subjects without MR, Y = 205 - 0.64 (age) (R = 0.52, SEE = 9.9 beats.min(-1); P < 0.01). A large sample Z test indicated that these regression coefficients were significantly different (P < 0.01). However, adding DS to the regression improved the prediction for subjects with MR, Y = 210 - (0.56 age) - (15.5 DS) (R = 0.57; SEE = 11.8 beats.min(-1), P < 0.01). CONCLUSION: MHR can be predicted with similar accuracy in subjects with and without MR, provided DS is accounted for in the equation for the subjects with MR.

Cross validation of the 1-mile walking test for men with mental retardation.

The purpose of this study was to cross validate the equation developed by Rintala et al. (1992) to estimate the cardiorespiratory efficiency of men with mental retardation (MR). Subjects were 19 healthy men (27 +/- 8 yr) with MR (IQ = 58 +/- 12). Following familiarization, a graded maximal treadmill test and two 1-mile walk tests (Rockport Fitness Walking Test, RFWT) were administered. The peak VO2 value was the criterion measure used to cross validate the equation. The equation was: Peak VO2 (ml.kg-1.min-1) = 101.92 - 2.356 (MILE)-0.420 (WEIGHT). The mean differences were 2.04 (MILE1)(P = 0.02) and 2.43 (MILE2)(P = 0.004) ml.kg-1.min-1. A significant positive correlation was found between measured peak VO2 and predicted peak VO2 on both 1-mile walks (r = 0.91 and 0.93). For both predicted peak VO2 values, the Total Error (TE) was greater than standard error of estimate (SEE), indicating a systematic difference between the measured and predicted peak VO2 values. Moreover, only 58% of the measured peak VO2 values fell within the prespecified range. Test-retest reliability of RFWT was R = 0.96. However, the prediction equation underestimated the actual cardiorespiratory levels in 74% and 79% of the subjects, depending on the trial. Because the equation developed in this research underestimates the measured VO2 values for the majority of these subjects, the test is probably not statistically valid, even if reliable, and the prediction formula needs to be revised for this population.

Cardiorespiratory capacity of individuals with mental retardation including Down syndrome.

This study evaluated the cardiorespiratory capacity of persons with MR with and without Down syndrome. Analyses of individual data records of maximal exercise tests with metabolic analyses were conducted on tests of 111 subjects (31 men and 16 women with DS; 35 men and 29 women without DS) from six participating centers. All centers used a walking treadmill protocol previously shown to produce valid and reliable maximal tests with this population. Peak oxygen uptake and peak minute ventilation were higher in men than in women (P < 0.006), and in subjects without DS (P < 0.006). Peak heart rate was also higher in subjects without DS (P < 0.006). Peak respiratory exchange ratio (RER) was higher in subjects without DS (P < 0.006). Using peak RER as a covariate did not change the results. An analysis of peak minute ventilation, heart rate and VO2 of subjects with a peak RER above 1.1 revealed the same results. These data show that individuals with mental retardation have low levels of peak VO2, consistent with low levels of cardiovascular fitness. Individuals with Down syndrome have even lower levels of peak VO2 than their peers without Down syndrome, a finding that is possibly mitigated by the lower peak heart rates of the individuals with Down syndrome.

Validity of a cardiorespiratory fitness test for men with mental retardation.

The purpose of this study was to validate a field test of cardiorespiratory fitness for men with mental retardation. The subjects were 19 healthy young men (26 +/- 6 yr) with moderate mental retardation (IQ = 48 +/- 11). Each subject underwent a maximal treadmill test after a three-phase familiarization process. Each subject also completed a 1-mile walk test twice (Rockport Fitness Walking Test = RFWT). The correlation coefficients between peak VO2 on the treadmill and the two 1-mile walks varied from 0.78 to 0.83. When weight, height, age, heart rates of 1-mile walks, and their combinations were held constant, the correlations were strengthened. Using multiple correlation analysis the best equation for predicting peak VO2 was: Peak VO2 = 101.92 - 2.356(mile-1 time) - 0.42(weight). This model accounted for 85% of total variance. The standard error of estimate was 4.06 ml.kg-1.min-1. The test-retest reliability of the RFWT for the 19 subjects used in this study was very high (R = 0.97). This finding suggests that the RFWT is a valid and reliable field test for this population and appears to be a valid indicator of cardiorespiratory fitness for these men with mental retardation.