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The aim of this study was to investigate the reliability and validity of the Trunk Control Measurement Scale (TCMS) among children with cerebral palsy (CP) who were living in Tanzania. Two physiotherapy trainees, each blinded to the other’s test findings, independently administered the TCMS to 38 children with CP (16 female; M age = 7.2, SD = 4.8 years) twice over sessions separated by a 30-day interval. We assessed internal consistency and intra/inter-rater reliability using Cronbach’s alpha and the Intraclass Correlation Coefficient (ICC), respectively. We examined measurement error through Standard Error of Measurement (SEM) and Minimal Detectable Change (MDC). We assessed construct validity with Spearman's correlation coefficient between the TCMS and both the Gross Motor Function Classification System (GMFCS) and the Manual Ability Classification System (MACS). We found a frank floor effect. Internal consistency (α = 0.945) and reliability indices were excellent for the total scale (ICC for intra-rater reliability = 0.985, inter- reliability = 0.997) and for each sub-scale score. We found low values of SEM (1.7 points) and MDC (4.8 points). Construct validity was supported by moderate and strong correlations between the TCMS and the GMFCS and MACS in this sample. We conclude that the psychometric properties of the TMCS support its clinical and research use for youth with CP in low-income settings.

Objectives: Gross Motor Function Classification System (GMFCS) and Manual Ability Classification System (MACS) are broadly studied in high-income countries, but data concerning their functioning are lacking in developing countries. Therefore, we analyzed their reliability and sensitivity to change in children with cerebral palsy in Tanzania. Methods: GMFCS and MACS are two ordinal grading systems used to assess motor functions while observing children’s performances. Forty-nine children were classified by two independent physiotherapy students at baseline, after one month and after one year. Reliability and sensitivity to change were analyzed using intraclass correlation coefficient (ICC), effect size (ES), standard response mean (SRM), standard error of measurement (SEM), and minimal detectable change (MDC). Results: Inter- (ICC = 0.97/0.95 for GMFCS/MACS) and intra-rater reliability (ICC = 0.98/0.96 GMFCS/MACS) were excellent. Sensitivity to change was small (ES = −0.14/0.11, SRM = −0.24;/0.24 GMFCS/MACS). SEM was 0.2 points, resulting in MDC = 0.5/0.7 for GMFCS/MACS, respectively. Conclusions: GMFCS and MACS demonstrated excellent reliability, but not sensitivity to change.

Patients with advanced heart failure refractory to medical therapy can be treated with left ventricular assist devices, implanted to augment or replace left ventricular function. The most common postoperative complications are infection; bleeding; thromboembolic events; device malfunction; depression, and neurological dysfunction (stroke, transient ischemic attacks, encephalopathy). Their onset contributes to the interruption and delay in commencing a physiotherapy program. During the initial postoperative phase, patients with left ventricular assist devices are not generally able to tolerate an intensive rehabilitative programme, but they may be able to do so in a more advanced stage of recovery. Physiotherapy in the early period prepares the patient for a more complex and articulated rehabilitation, usually scheduled after hospital discharge. Supervised exercise should be implemented once the patient has been thoroughly instructed on how the device works and after a checklist to ensure that the patient understands the workings of the device, has been signed off. Although several studies have been published discussing postoperative rehabilitation in LVAD patients, to date it is not available yet an illustrated guide describing basic movements. Here, we describe a series of supervised physical exercises that can be executed daily. We aimed to illustrate a set of basic movements preparatory to a more complex and articulated exercise programme. A range of exercises involving all body parts is described as lying, sitting and standing postures.