Reproducibility of two functional field exercise tests for children with cerebral palsy who self-propel a manual wheelchair
Correspondence to Dr Olaf Verschuren, Rehabilitation Centre De Hoogstraat, Rembrandtkade 10, 3583 TM Utrecht, the Netherlands.
The aim of this study was to examine the test–retest reproducibility (reliability and agreement) of the 6-minute push test (6MPT) and the one-stroke push test (1SPT), and construct validity of the 6MPT in children with cerebral palsy (CP) who self-propel a manual wheelchair.
Seventy-three children and adolescents with spastic CP (51 males, 22 females; mean age 11y 9mo, SD 3y 7mo, range 4–18y; three unilateral, 70 bilateral) using a manual wheelchair for at least part of the day were recruited from and tested in different rehabilitation settings in the Netherlands and Brazil. Participants were classified as Gross Motor Function Classification System (GMFCS) level II (n=7), III (n=36), or IV (n=30).
Intraclass correlation coefficients (ICCs) for distance covered on the 6MPT (mean distance 266.5m, SD 120.6m) and the 1SPT (mean distance 4.5m, SD 2.7m) showed excellent reliability (ICC=0.97) for both tests. There was a significant correlation between the 6MPT and the 1SPT (r=0.73; p<0.001), and between the 6MPT and heart rate during the 6MPT (r=0.29, p=0.014).
These results indicate that both the 6MPT and the 1SPT test are reproducible functional tests for young people with CP who self-propel a wheelchair. Agreement for the 6MPT seems relatively large for children who perform short distances. Construct validity is supported for the 6MPT in children with CP.