COSMIN database

Reliability and Responsiveness of Upper Limb Motor Assessments for Children With Central Neuromotor Disorders: A Systematic Review

Gerber, C. N., Labruyere, R., and van Hedel, H. J.
BACKGROUND: To investigate the effectiveness of upper limb rehabilitation, sound measures of upper limb function, capacity, and performance are paramount.

OBJECTIVES: This systematic review investigates reliability and responsiveness of upper limb measurement tools used in pediatric neurorehabilitation.

METHODS: A 2-tiered search was conducted up to July 2014. The first search identified upper limb motor assessments for 1- to 18-year-old children with neuromotor disorders. The second search examined the psychometric properties of the tools. Methodological quality was rated according to COSMIN guidelines, and results for each tool were assembled in a "best evidence synthesis." Furthermore, we delineated whether tools were unimanual or bimanual tests and if they measured recovery or did not distinguish between physiological and compensatory movements.

RESULTS: The first search delivered 2546 hits. Of these, 110 articles on 51 upper limb assessment tools were included. The second search resulted in 58 studies on reliability, 11 on measurement error, and 10 on responsiveness. Best evidence synthesis revealed only 2 assessments with moderate positive evidence for reliability, whereas no evidence on measurement error and responsiveness was found. The Melbourne Assessment showed moderate positive evidence for interrater and a fair positive level of evidence for intrarater reliability. The Pediatric Motor Activity Log Revised revealed moderate positive evidence for test-retest reliability.

CONCLUSIONS: There is a lack of high-quality studies about psychometric properties of upper limb measurement tools in children with neuromotor disorders. To date, upper limb rehabilitation trials in children and adolescents risk being biased by insensitive measurement tools lacking reliability.
Neurorehabil Neural Repair
1552-6844 (Electronic)
Publication year:
Symptom status:
Physical state
Functional status:
Role functioning
Children (0-18)
Congenital malformations, deformations and chromosomal abnormalities and related symptoms
Diseases of and symptoms related to the nervous system
Injury, poisoning and certain other consequences of external causes
PRO / non-PRO:
Non-patient Reported Outcome
Type of measurement instrument:
1 - Questionnaires
2 - Interviews
7 - Observations
Accelerometry [alias: accelerometer]
AHA - Assisting Hand Assessment
BFMF - Bimanual Fine Motor Function
House Functional Classification System
MACS - Manual Ability Classification System
M-ADL - Münchner ADL-Fragebogen “Hand skill in everyday life” subscale
MAS - Modified Ashworth Scale   
MMT - Manual muscle testing
Modified House Functional Classification
Mowery classification
MUUL - Melbourne Assessment of Unilateral Upper Limb Function (versions: MUUL-2)
OSAS - Observational Skills Assessment Score
PAFT - Pediatric Arm Function Test
PDMS-2 - Peabody Developmental Motor Scales-2
PDMS - Peabody Developmental Motor Scales
PMAL-R - Revised Pediatric Motor Activity Log
PODCI - Pediatric Outcomes Data Collection Instrument (versions: PODCI-UE - PODCI-Upper Extremity; PODCI-parent proxy form)
QUEST - Quality of Upper Extremity Skills Test
SHUEE - Shriners Hospital Upper Extremity Evaluation
Tonic stretch reflex testing
TS - Tardieu Scale (versions: MTS - Modified TS)
UE-CAT - Shriners Hospitals for Children Cerebral Palsy Computer-Adapted Testing Battery Upper Extremities
UERS - Upper Extremity Rating Scale
VOAA-DDD-R - Video Observation Aarts and Aarts module: Determine Developmental Disregard Revised
VOAA-DDD - Video Observation Aarts and Aarts module: Determine Developmental Disregard