Abstract

To assess the reliability and validity of the Chinese version of the Selective Control Assessment of the Lower Extremity (SCALE) in children with spastic cerebral palsy (CP). Forty-five children with spastic CP (mean age 7.29 years, SD 2.87 years, rang 4-16 years) were recruited. Internal consistency was measured using Cronbach's α, while test-retest and inter-rater reliability were evaluated using intra-class correlation coefficients (ICC). Construct validity was established through correlation and confirmatory factor analyses. Discriminative validity was assessed by comparing SCALE scores across varying GMFCS levels. The Chinese version of SCALE demonstrates high internal consistency (Cronbach's α = 0.91) and good reliability with ICCs exceeding 0.76 for test-retest and inter-rater assessments. It shows significant correlations with GMFCS (r = -0.76, p < 0.001) and Fugl-Meyer scales (r = 0.79, p < 0.001), confirming its validity. Confirmatory factor analysis supports a well-fitting model (χ 2/df = 1.58, RMSEA = 0.08, SRMR <0.001, GFI = 0.98, AGFI = 0.90, CFI = 0.99, TLI = 0.98), with the latent variable's AVE at 0.59 and CR at 0.88. Discriminative validity is evident in significant differences across GMFCS levels (p < 0.001), notably between levels I and II, I and III, and I and IV (p < 0.05). The Chinese version of SCALE shows good reliability and validity for assessing lower limb selective movement control in children with spastic cerebral palsy in China. https://www.chictr.org.cn/showproj.html?proj=205380, identifier ChiCTR2400083880.

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