Objective: To evaluate psychometrics of wearable devices measuring physical activity (PA) in ambulant children with gait abnormalities due to neuromuscular conditions. Data Sources: We searched PubMed, Embase, PsycINFO, CINAHL, and SPORTDiscus in March 2023. Study Selection: We included studies if (1) participants were ambulatory children (2-19y) with gait abnormalities, (2) reliability and validity were analyzed, and (3) peer-reviewed studies in the English language and full-text were available. We excluded studies of children with primarily visual conditions, behavioral diagnoses, or primarily cognitive disability. We performed independent screening and inclusion, data extraction, assessment of the data, and grading of results with 2 researchers. Data Extraction: Our report follows Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We assessed methodological quality with Consensus-based Standards for the selection of health measurement instruments. We extracted data on reported reliability, measurement error, and validity. We performed meta-analyses for reliability and validity coefficient values. Data Synthesis: Of 6911 studies, we included 26 with 1064 participants for meta-analysis. Results showed that wearables measuring PA in children with abnormal gait have high to very high reliability (intraclass correlation coefficient [ICC]+, test-retest reliability=0.81; 95% confidence interval [CI], 0.74-0.89; I2=88.57%; ICC+, interdevice reliability=0.99; 95% CI, 0.98-0.99; I2=71.01%) and moderate to high validity in a standardized setting (r+, construct validity=0.63; 95% CI, 0.36-0.89; I2=99.97%; r+, criterion validity=0.68; 95% CI, 0.57-0.79; I2=98.70%; r+, criterion validity cutoff point based=0.69; 95% CI, 0.58-0.80; I2=87.02%). The methodological quality of all studies included in the meta-analysis was moderate. Conclusions: There was high to very high reliability and moderate to high validity for wearables measuring PA in children with abnormal gait, primarily due to neurological conditions. Clinicians should be aware that several moderating factors can influence an assessment.
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BackgroundWe report development of the SPQ (School Participation Questionnaire) a teacher-completed measure of participation related constructs for schools. The SPQ was developed to support participation-related assessment, interventions, and research in the inclusive school context.MethodsSeveral iterative steps were undertaken. An international panel of experts reviewed content validity. A 66-item pilot questionnaire was administered in schools. Mokken and Rasch model analysis were applied. Internal consistency was assessed using Cronbach’s alpha. Analyses were conducted on associations with teacher and child demographic variables. Feedback was sourced from users. Participants were teachers of 101 children (5−12 years old) with a range of disabilities, including intellectual disability, autism spectrum disorder and learning difficulties.ResultsFour participation-related dimensions of the SPQ were confirmed. Rasch person and item reliability were good, and 2–4 strata were confirmed per scale. Internal consistency was good (all scales, Cronbach α > 0.8). Mean administration time was 11.7 min. Mean SPQ scores were independent of teacher characteristics. A significant effect of school support level, eligibility for free school meals and gender was found. Through synthesising analytic results and feedback, a new 46-item tool was obtained.ConclusionThe results of this study provide evidence of acceptability, practicality and validity. The SPQ is the first tool developed to assess participation related constructs in schools, and it contains novel information not given by other assessments. The SPQ may be used by practitioners and researchers to understand and improve the participation of children with a range of disabilities in schools.
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AIM: To explore concurrent validity, convergent validity, interrater reliability, test-retest reliability, and Rasch model analysis of the School Participation Questionnaire (SPQ), a tool for teachers to assess personal and environmental determinants of school participation.METHOD: Teachers of children with additional support needs, including intellectual disability, autism, and learning difficulties completed measures. Data were collected using the SPQ and the Participation and Environment Measure for Children and Youth (PEM-CY). Test-retest and interrater reliability were assessed using intraclass correlation coefficients (ICCs). Internal consistency was assessed with Cronbach's alpha. Concurrent and convergent validity were explored via correlations with the PEM-CY. Further psychometrics were examined using a Rasch model.RESULTS: One hundred and eighty-seven children (136 [72.7%] male; mean age 9y [range 5y 6mo-12y 10mo, SD 2y]) were assessed by 67 teachers. Cronbach's alpha, test-retest, and interrater reliability were acceptable-excellent across each SPQ scale (alphas=0.89, 0.9, 0.94, 0.79; test-retest ICCs=0.64, 0.61, 0.78, 0.62; interrater ICCs=0.85, 0.71, 0.90, 0.81). Concurrent and convergent validity were confirmed with significant positive correlations between SPQ and PEM-CY. After Mokken and Rasch model analysis, person and item reliability were good, and unidimensionality was confirmed. Mean administration time was 8.2 minutes.INTERPRETATION: The results suggest that the SPQ is a rapid, reliable, and valid tool for assessment of participation-related indicators in schools.
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