Article Review – The Feasibility and Concurrent Validity of Performing the MABC-2 via Telerehabilitation Technology
Purpose: Kristy Nicola, Jemimah Waugh, Emily Charles, and Trevor Russell examined the feasibility of administering the Movement Assessment Battery for Children-2nd Edition (MABC-2), to local school children between the ages of five and eleven, with both an in person administration as well as a tele-rehabilitation administration and comparing the validity of the two.
Study Population: Fifty nine typically developing children, between the ages of five and eleven, who were all enrolled at the same state school were used for this study. Children were excluded from the study if they had a previous diagnosis that would impact their motor capabilities, were born prematurely, or did not require any additional support to complete day to day school activities.
Methods: The children participating in this study were administered the MABC-2 twice. Once was in an outdoor area on their school grounds in the presence of a trained pediatric physiotherapist, or physiotherapy student. The other was in a different outdoor area on school grounds with only the presence of a teaching aide and an iPad in which the physiotherapist would administer the test remotely via the iPad. The children were scheduled to be tested sequentially in one day, with the order of the tests randomized for each child as well as a different physiotherapist administering each of the tests. After the administration of both tests, students took a satisfaction survey that elicited feedback on the time requirement and preference regarding the two tests.
Outcome Measures: In this article researchers studied the Movement Assessment Battery for Children – 2nd edition (MABC-2), utilizing all three subtests (manual dexterity, aiming and catching, and balance), to investigate the feasibility and validity of administering the test remotely via an online platform compared to a traditional in person administration.
Intervention: Due to the design of this study, the focus was more on the test rather than the results of any intervention. As a result, no interventions were provided to the children participating in this study.
Results: Comparison of the mean absolute difference (MAD) and the percentage agreement found that 31.67% of the total tests scores were exactly the same, and 100% of the total test scores were within 3 points of each other. The examinations found that most participants scored similarly enough on the two tests to end up in the same overall category, however three participants scored higher with in-person examinations, and two participants scored higher on the remotely administered test. From the results of the post-testing survey, more students expressed preference for doing an in person assessment next time (39.2%), compared to a smaller number that preferred using the iPad (15.7%), with the remaining students have no preference either way.
Strengths: This study did an excellent job of attempting to test the student’s capabilities without caregiver influence. During the remote administration via tele-rehabilitation technology, students received no help and minimal cuing from a teacher’s aide to encourage them to stay on task. This seems like the most likely scenario as many caregivers cannot fully participate in physiotherapy sessions. The study also gathered data regarding the children’s input on length of testing as well as their preference, with many of the children expressing no preference on testing and split on which test was longer, which is valuable information when working with this population.
Limitations: The major limitation of the study was the ability to recreate an appropriate remote environment to test. Students were tested in a familiar environment at their school, with necessary space and the equipment for the MABC-2 was provided. In addition, although the school originally did not have WiFi, a 4G hotspot was created in order to ensure that school had adequate bandwidth to use the technology to participate in the remote administration. Considering the students were tested in a familiar setting, with functioning WiFi, with the equipment provided it can raise questions on how practical that is for remotely located families to provide the same setup. The researchers also acknowledged that students were tested in a very small timeframe, acknowledging that their students’ scores could have been influenced by them having previously completed the tasks.
Conclusion: This study does demonstrate that it is possible to complete the MABC-2 remotely with results that would be consistent to that of an in person administration. However prior to administering this test, providers should consider the students setup, equipment, and bandwidth capabilities in order to ensure that results are as accurate as possible. This study also encourages additional research on the feasibility of telehealth with patients who live remotely or lack the services that they need.
Reference: Nicola, Kristy, et al. “The Feasibility and Concurrent Validity of Performing the Movement Assessment Battery for Children – 2nd Edition via Telerehabilitation Technology.” Research in Developmental Disabilities, vol. 77, June 2018, pp. 40–48. PubMed, doi:10.1016/j.ridd.2018.04.001.
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Great choice for an article especially given the current environment with Tele PT! I am curious to know the MCID for the M-ABC and how would you use the MCID to interpret the difference between raters/scores?