Commentary on “Scoring People With Spinal Muscular Atrophy on the Motor Function Measure Using the Microsoft Kinect”

Abstract

“How could I apply this information?” The Motor Function Measure (MFM) is used to evaluate children with type 2 or type 3 spinal muscle atrophy (SMA). This study provides a starting point for using digital capture to supplement a therapist's scoring and presents the challenges of digital capture for children with movement impairments. The results indicate that use of digital capture is most reliable for children with SMA type 3, likely because they can perform larger magnitude movements and the standing items. Reliability is optimized when sitting items are performed outside of the child's wheelchair. Future research should consider digital capture as a supplement to in-person assessments to decrease scoring variability, especially as children with SMA often compensate to complete tasks. “What should I be mindful about when applying this information?” The authors acknowledge results limit the use of Kinect digital capture as an alternative to therapist assessment of those with a limited motor repertoire beyond sitting and required assistance of an engineer. In addition, digital capture did not enhance the interrater reliability among therapists scoring the MFM. Small sample size and limited items with full agreement indicate that digital capture would provide little benefit to the therapist in clinical practice. This may provide a foundation for future investigation. As parents of a child with SMA who is used to being exposed to new people, equipment, and therapies, I feel he would adapt well to using digital capture in addition to therapist assessment. Although there is always variability among therapists, I hesitate to trust results from digital capture after reviewing this study. I would want to ensure both in-person and digital scores were similar before being comfortable with digital capture. It would be helpful if future research could focus on the benefits of digital assessment including reliability, time-efficiency, and ease of scoring. Mallory Gardner, PT, DPT, PCS Nathalie Musey, PT, DPT, PCS Allan M. Glanzman, PT, DPT, PCS Physical Therapy Department Children's Hospital of Philadelphia Philadelphia, Pennsylvania