Reliability of the Motor Learning Strategies Rating Instrument in physiotherapy intervention for children with cerebral palsy

Abstract

Aim: To evaluate the reliability of the Motor Learning Strategies Rating Instrument (MLSRI-20) in gait-based, video-recorded physiotherapy interventions for children with cerebral palsy (CP). Method: Thirty videos of 18 children with CP, aged 6 to 17 years, participating in either traditional or Lokomat-based physiotherapy interventions were rated using the MLSRI-20. Physiotherapist raters provided general and item-specific feedback after rating each video, which was used when interpreting reliability results. Results: Both interrater and intrarater reliability of the MLSRI-20 total score was good. The interrater reliability intraclass correlation coefficient (ICC) was 0.78 with a 95% confidence interval (CI) of 0.53–0.89 and a coefficient of variation (CV) of 11.8%. The intrarater reliability ICC was 0.89 with a 95% CI of 0.76–0.95 and CV of 7.8%. Rater feedback identified task delineation and interpretation of therapist verbalizations as sources of interrater reliability-related scoring challenges. Interpretation: The MLSRI-20 is a reliable tool for measuring the extent to which a physiotherapist uses motor learning strategies during a video-recorded intervention. These results have clinical and research implications for documenting and analyzing the motor learning content of physiotherapy interventions for children with CP. What this paper adds: The Motor Learning Strategies Rating Instrument (MLSRI-20) is reliable for use by trained physiotherapist raters. Measuring motor learning strategies can identify active ‘ingredients’ in physiotherapy interventions for children with cerebral palsy. The MLSRI-20 promotes a common language in motor learning.