The Sarah evaluation scale for children and adolescents with cerebral palsy: description and results

BACKGROUND: Assessments of motor-functional aspects in cerebral palsy are crucial to rehabilitation programs. OBJECTIVE: To introduce the Sarah motor-functional evaluation scale and to report the initial results of its measurement properties. This scale was created based on the experience of the Sarah Network of Rehabilitation Hospitals in the care of children and adolescents with cerebral palsy. METHOD: Preliminary results concerning the measurement properties of the scale were obtained via assessment of 76 children and adolescents with cerebral palsy. Experts' opinions were used to determine an expected empirical score by age group and to differentiate severity levels. RESULTS: The scale exhibited a high Cronbach’s alpha coefficient (0.95). Strong correlation was observed with experts’ classification for severity levels (0.81 to 0.97) and with the scales Gross Motor Function Measure and Pediatric Evaluation of Disability Inventory (0.80 to 0.98). Regression analysis detected a significant relationship between the scale score and the severity of the child’s motor impairment. The inter-rater reliability was also strong (intraclass correlation coefficient ranging from 0.98 to 0.99). The internal responsiveness of the scale score was confirmed by significant differences between longitudinal evaluations (paired Student’s t test with p<0.01; standardized response mean of 0.60). CONCLUSION: The Sarah scale provides a valid measure for assessing the motor skills and functional performance of children and adolescents with cerebral palsy. The preliminary results showed that the Sarah scale has potential for use in routine clinical practice and rehabilitation units.