[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-439152-105":59,"doc-detail-439152-en":129},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":122,"head_meta":124,"extra_data":126,"updated_unix":128},105,"en","precision-rehabilitation-for-cerebral-palsy-will-require-robust-measures-of-motor-control-development-commentary","Precision rehabilitation for cerebral palsy will require robust measures of motor control development - Commentary","","The commentary addresses cerebral palsy (CP) as a heterogeneous condition whose core deficit lies in impaired development of motor control, with selective motor control (SMC) emerging as a stronger predictor of function than spasticity, weakness, or contracture. It evaluates the Mini-SCALE for assessing lower-limb SMC in children aged 3 months to 4 years, discussing evidence for clinical feasibility and validity while highlighting gaps in reliability data. Key limitations include hip joint scoring in infants under 9 months and concerns about construct validity, emphasizing the need for longitudinal, age-stratified testing and tools sensitive to change for precision rehabilitation.",{"@graph":69,"@context":121},[70,84,104],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":40,"@type":76,"position":81},"https://docshare.wps.com/document/research-report/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/precision-rehabilitation-for-cerebral-palsy-will-require-robust-measures-of-motor-control-development-commentary/439152/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":98,"encodingFormat":97,"isAccessibleForFree":99,"interactionStatistic":100},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/precision-rehabilitation-for-cerebral-palsy-will-require-robust-measures-of-motor-control-development-commentary/439152.png","ImageObject",300,407,{"name":92,"@type":93},"Jake","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-09-29",true,{"@type":101,"interactionType":102,"userInteractionCount":14},"InteractionCounter",{"@type":103},"ViewAction",{"@type":105,"mainEntity":106},"FAQPage",[107,113,117],{"name":108,"@type":109,"acceptedAnswer":110},"Why does the commentary emphasize motor control development in cerebral palsy?","Question",{"text":111,"@type":112},"Because across CP severity and phenotype, the primary deficit is the poor development of motor control. Selective motor control is repeatedly described as a better predictor of function than spasticity, muscle weakness, or joint contracture.","Answer",{"name":114,"@type":109,"acceptedAnswer":115},"What is the Mini-SCALE intended to do, and for which age group?",{"text":116,"@type":112},"The Mini-SCALE is designed for children with or at risk for CP between 3 months and 4 years old, advancing assessment of lower-limb selective motor control to bridge the gap between BabyOSCAR and SCALE.",{"name":118,"@type":109,"acceptedAnswer":119},"What limitations are raised about the Mini-SCALE scoring approach?",{"text":120,"@type":112},"The commentary notes missing reliability data and challenges with hip joint scoring in infants under 9 months, including uncertainty about interpreting total scores when hip items behave differently and concerns about construct validity related to muscle weakness.","https://schema.org",{"og:url":83,"og:type":123,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":125,"canonical":83},"index,follow",{"doc_id":127,"site_id":62},439152,1790716844,{"code":4,"msg":5,"data":130},{"doc_id":127,"user_id":131,"nickname":92,"user_avatar":132,"doc_module":4,"category_id":39,"category_name":40,"doc_title":65,"doc_description":67,"doc_content":133,"file_id":134,"file_url":135,"file_type":136,"file_size":137,"view_count":14,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":14,"language":138,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":139,"faqs":140,"seo_title":141,"seo_description":67,"update_tm":142,"read_time":24},962084928904,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","DOI: 10. 1111/dmcn.16460  \nC OM M E N TA RY  \nPrecision rehabilitation for cerebral palsy will require robust measures of motor control development  \nLaura A. Prosser1,2   \n1Division of Rehabilitation Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA, USA 2Department of Pediatrics, University of Pennsylvania, Philadelphia, PA, USA  \nDespite wide heterogeneity in the severity and phenotype of cerebral palsy (CP), universally, the primary deficit is the poor development of motor control.1 In fact, impairment in selective motor control (SMC) has repeatedly been a better predictor of function than spasticity, muscle weakness, or joint contracture.2 Yet the development of motor control is not routinely measured due to the scarcity of measurement tools.  \nDesigned for children with or at risk for CP between 3 months and 4years of age, the Mini-SCALE3 advances assessment oflower limb SMC in young children, bridging the age gap between the BabyOSCAR4 and SCALE.5 This age range is particularly important because motor control impairments in young children with CP maybe more amenable to treatment than in older children, before the neural pathways that support movement are established and less flexible.  \nStaudt et al.'s study provides evidence of clinical feasibility and of content and construct validity for the Mini-SCALE.3 Regrettably, it does not include reliability data. Scores from younger infants and in the grade of ‘impaired’ (1 point) may demonstrate lower reliability than from older children and in the ‘normal’ (2 points) and ‘unable’ (zero points) grades. It also appears that most children who were at risk for CP, and some with diagnosed CP, scored within the range observed in the typically developing cohort, suggesting that Mini-SCALE may identify severe–moderate cases but miss cases of mild CP. Thorough investigations of reliability and predictive validity by age, joint, and rank score are needed to guide interpretation related to early detection of risk for CP in the context of developmental maturation.  \nDifficulty with hip joint scoring in infants under 9 months of age presents a significant limitation. The authors propose interpreting a total score of 8 (rather than 10) as normal for this age (disregarding the hip score but not omitting the item from testing). It is unclear how a total score of 8 or 9 should be interpreted in children  \nunder 9 months if any joint other than the hip scores \u003C2, as might be expected often in children with mild bilateral (diplegia) or unilateral (hemiplegia) CP. From a theoretical perspective, the authors suggest that muscle weakness, not poor SMC, is the primary factor in hip scores \u003C2 in younger infants with typical development, which implies inadequate construct validity of this item. This concern could be addressed in a future revision of the hip item—perhaps to allow a partially flexed knee posture so long asthe knee joint is not moving during hip movement (given the reported challenges also with testing the hip in sidelying). These questions underscore the need for longitudinal testing in an age-stratified sample.  \nThe Mini-SCALE is a commendable first step addressing the need for clinically feasible measures of lower limb SMC that can be administered in infants and young children. It has potential to guide the selection of early intervention strategies, based on the general degree of SMC impairment in each lower limb. However, like other ordinal scales (e.g. the SCALE and Gross Motor Function Classification System), it is not designed tobe sensitive to change overtime or after intervention. Tools that offer greater precision on the type, location, and magnitude of SMC impairment have potential to complement these ordinal clinical scales to improve the prediction of CP subtyping (including non-spastic types and severity level) and to serve as sensitive endpoints for clinical trials—both critical factors in moving the field toward precision rehabilitation.  \nWith adva","cbCainGNp9MD3IPu","https://ap.wps.com/l/cbCainGNp9MD3IPu","pdf",90776,"English","# Precision rehabilitation for cerebral palsy will require robust measures of motor control development\n## Clinical rationale: SMC as a predictor\n## Mini-SCALE assessment and age relevance\n## Validity evidence and reliability gaps\n## Limitations in hip scoring under 9 months\n## Implications for precision rehabilitation and trials","[{\"question\":\"Why does the commentary emphasize motor control development in cerebral palsy?\",\"answer\":\"Because across CP severity and phenotype, the primary deficit is the poor development of motor control. Selective motor control is repeatedly described as a better predictor of function than spasticity, muscle weakness, or joint contracture.\"},{\"question\":\"What is the Mini-SCALE intended to do, and for which age group?\",\"answer\":\"The Mini-SCALE is designed for children with or at risk for CP between 3 months and 4 years old, advancing assessment of lower-limb selective motor control to bridge the gap between BabyOSCAR and SCALE.\"},{\"question\":\"What limitations are raised about the Mini-SCALE scoring approach?\",\"answer\":\"The commentary notes missing reliability data and challenges with hip joint scoring in infants under 9 months, including uncertainty about interpreting total scores when hip items behave differently and concerns about construct validity related to muscle weakness.\"}]","Precision rehabilitation for cerebral palsy will require robust measures of motor control development - Commentary | PDF",1790687583]