Psychometric and Clinimetric Properties of the Melbourne Assessment 2 in Children With Cerebral Palsy.

ABSTRACT

OBJECTIVE: To examine the psychometric and clinimetric properties of the Melbourne Assessment 2 (MA2), an outcome measurement that is increasingly used in clinical studies. DESIGN: Psychometric and clinimetric study. SETTING: Community. PARTICIPANTS: Seventeen children with cerebral palsy (CP) from 5 to 12 years were recruited for the estimation of the test-retest reliability and minimal detectable change (MDC). Thirty-five children with CP were recruited to receive an 8-week intensive neurorehabilitation intervention to estimate the validity, responsiveness, and minimal clinically important difference (MCID). INTERVENTIONS: Thirty-five children with CP received upper limb neurorehabilitation programs for 8 weeks. MAIN OUTCOME MEASURES: The MA2 and the criterion measures, including the Bruininks-Oseretsky Test of Motor Proficiency, 2nd edition (BOT-2), the Box and Blocks Test (BBT), and the Pediatric Motor Activity Log-Revised (PMAL-R), were evaluated at pretreatment and posttreatment. RESULTS: The MA2 has 4 subscales range of motion, fluency, accuracy, and dexterity. The test-retest reliability of the MA2 is high (intraclass correlation coefficient, .92-.98). The significant relationships between the MA2 and BBT, BOT-2, and PMAL-R support its validity. The significance of paired t test results (P<.001) and large magnitudes of the standardized response mean (1.70-2.00) confirm the responsiveness of the MA2. The MDC values of the 4 subscales of the MA2 are 2.85, 1.63, 1.97, and 1.84, respectively, and the suggested MCID values of these 4 subscales are 2.35, 3.20, 2.09, and 2.22, respectively, indicating the minimum scores of improvement to be interpreted as both statistically significant and clinically important. CONCLUSIONS: The study findings indicate that the MA2 has sound psychometric and clinimetric properties and is thus an adequate measurement for research and clinical applications.