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RehabMeasures Instrument

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Purpose

Evaluates anaerobic performance of youth who run or propel a wheelchair.

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Instrument Details

Acronym MPST

Area of Assessment

Functional Mobility

Cost

Not Free

Actual Cost

$0.00

Key Descriptions

  • 6 x 15-meter maximum effort running sprints (with orthoses as needed) separated by 10-second rest periods (Verschuren, Takken, Ketelaar, Gorter, & Helders, 2007).
  • 3-4 x 15-meter maximum effort wheelchair propelled sprints separated by 10-second rest periods (Bloemen, Takken, Backx, Vos, Kruitwagen, & de Groot, 2017; Verschuren & Takken, 2014).
  • For wheelchair, self-propulsion tests subjects use their own wheelchair and wheelchair mass is adjusted for in the power calculation (Bloemen et al., 2017).
  • Testing of anaerobic power is the goal. Because anaerobic glycolysis is the primary energy source in physical activity for the first 30 seconds, the total number of repetitions should be modified, depending on the function and mode of propulsion of the subjects, to achieve ~30 seconds total sprint time, excluding rests (Bloemen et al., 2017).
  • 2 power variables are calculated:
    1) Peak Power (PP), measured as the highest of 6 runs
    2) Mean Power (MP), measured as the average over 6 runs (Verschuren et al., 2007).
  • PP was defined as the highest calculated power output. MP is considered the most important parameter during anaerobic performance and was defined as the average power output over all of the runs (Verschuren et al., 2007).
  • Items are scored for power in runners where:
    Power = (total body mass x 15 m2) / time 3 (to the 100th of a second) (Verschuren, Bongers, Obeid, Ruyten, & Takken, 2013a).
  • Items scored for power in wheelchair users where: total mass = body mass + wheelchair mass: power = (total mass x 15m2)/time3 (to the 100th of a second) (Verschuren, Zwinkles, Obeid, Kerkhof, Ketelaar, & Takken, 2013b).

Number of Items

1

Equipment Required

  • Stop watch
  • Floor tape
  • 4 cones
  • 15 meters of measuring tape
  • Anthropometric weight scale for runners or wheelchair weight scale for wheelchair users

Time to Administer

1-5 minutes

Required Training

Reading an Article/Manual

Instrument Reviewers

Erin Ulrich MS, LAT, ATC

ICF Domain

Activity

Considerations

  • The gold standard measure of anaerobic muscle power, WAnT, is not clinically feasible due to expensive lab-based equipment.

  • The MSPT is shown to be highly feasible via questions regarding feasibility for ambulatory children with CP and their assessors. Questions were related to ease and motivation (Verschuren et al., 2007).

  • Total time of all trials should fall around 30 seconds to measure anaerobic system. Thus, the normal 6 repetitions should be reduced for youth with cerebral palsy or spina bifida who’s impaired function result in a longer than normal total sprint time.

  • Recommendations are to use 3 sprints with wheelchair using spastic CP (GMFC III-IV) population (Verschuren, Zwinkles, 2013) and 4 sprints with wheelchair using spina bifida population (Bloemen et al., 2017).

  • The MPST is dependent on each child’s motivation. The child should be encouraged to give maximal effort, however, methods of encouragement are not standardized.

  • All studies for various populations are focused on youth (aged 6-19 years). Caution should be used in generalizing these data for populations falling outside of these age ranges.

  • All studies reviewed were performed in the Netherlands.

Cerebral Palsy

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Standard Error of Measurement (SEM)

Spastic Cerebral Palsy age 7-18 years: (Verschuren, Takken, Ketelaar, Gorter, & Helders, 2007; tested while running; Dutch sample)

GMFC level I: (n = 15; mean age = 11.6 (2.8) years)

  • SEM Peak Power: 13.9 watts

  • SEM Mean Power: 9.0 watts

GMFC level II: (n = 11; mean age = 10.9 (2.4) years)

  • SEM Peak Power: 13.9 watts

  • SEM Mean Power: 9.0 watts

Minimal Detectable Change (MDC)

Spastic Cerebral Palsy (GMFC level I-II) aged 7-18 years: (Verschuren et al., 2007)

  • MDC Peak Power: 38.5 watts (calculated from SEM)

  • MDC Mean Power: 25.0 watts (calculated from SEM)

Normative Data

Spastic Cerebral Palsy (GMFC level I-II) aged 7-18 years: (Verschuren, Bongers, Obeid, Ruyten, & Takken, 2013a; n = 20; mean age = 14.8 (2.0) years, subjects were from a special education school in an unidentified location; tested via running)

  • Peak Power (PP): mean = 250.3 watts; SD = 41.9; range = 41.4-799.0

  • Mean Power (MP): mean = 194.7 watts; SD = 33.1; range = 37.4-638.4

Test/Retest Reliability

Spastic Cerebral Palsy (GMFC level I-II) age 7-18 years: (Verschuren et al., 2007)

  • Excellent test-retest reliability for Peak Power (PP) (ICC = 0.98)

  • Excellent test-retest reliability for Mean Power (MP) (ICC = 0.99)

Spastic Cerebral Palsy (GMFC-E&R level III-IV) age 7-18 years: (Verschuren, Zwinkels, Obeid, Kerkhof, Ketelaar, & Takken, 2013b; n = 23; tested via wheelchair self-propulsion)

  • Excellent test-retest reliability for Peak Power (PP) (ICC = 0.99)

  • Excellent test-retest reliability for Mean Power (MP) (ICC = 0.99)

Interrater/Intrarater Reliability

Spastic Cerebral Palsy (GMFC level I-II) age 7-18 years: (Verschuren et al., 2007)

  • Excellent interrater reliability for Peak Power (PP) (ICC = 0.97)

  • Excellent interrater reliability for Mean Power (MP) (ICC = 0.98)

Criterion Validity (Predictive/Concurrent)

Concurrent

The Wingate Anaerobic Test (WAnT) is considered the gold standard in anaerobic muscle testing.

Spastic Cerebral Palsy (GMFC level I-II) age 7-18 years: (Verschuren et al., 2013a)

  • Excellent correlation between Peak Power (PP) arm cranking WAnT and MPST (r = .73; p < .001)

  • Excellent correlation between Mean Power (MP) arm cranking WAnT and MPST (r = .90; p < .001)

Spastic Cerebral Palsy (GMFC level III-IV) (wheelchair users) age 7-18 years: (Verschuren et al., 2013b)

  • Excellent correlation between Peak Power (PP) arm cranking WAnT and MPST (r = .91)

  • Excellent correlation between Mean Power (MP) arm cranking WAnT and MPST (r = .88)

Construct Validity

Discriminant

Spastic Cerebral Palsy (GMFC level I-II) age 7-18 years: (Verschuren et al., 2007)

  • Significant difference in PP MPST found between GMFCS I and GMFCS II groups (p = .007)

  • Significant difference in MP MPST found between GMFCS I and GMFCS II groups (p = .006)

Content Validity

Spastic Cerebral Palsy (GMFC level III-IV) (wheelchair users) aged 7-18 years: (Verschuren et al., 2013b)

  • The WAnT is a timed test (30s). The MPST is performed for a distance with the intent of averaging 30s total sprint time. Depending on function of the child (i.e., a slower runner or wheelchair user), the prescribed 6 repetitions may take longer than 30s, resulting in increased recruitment of aerobic energy sources. In this study, the number of repetitions was reduced to 3 to achieve the goal - maximal effort for 30s.

  • Recommendation is to use 3 sprints with this population.

Non-Specific Patient Population

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Standard Error of Measurement (SEM)

Typically developing children aged 6-12: (Douma-van Riet, Veschuren, Jelsma, Kruitwagen, Smits-Engelsman, & Takken, 2012; n = 379; mean age = 8.9 (1.7) years; tested via running; Dutch sample)

  • SEM Peak Power: 13.7 watts (calculated from test-retest reliability)

  • SEM Mean Power: 12.1 watts (calculated from test-retest reliability)

Typically developing children aged 6-18: (Steenman, Veschuren, Rameckers, Douma-van Riet, & Takken, 2016; n = 683; mean age = 11.9 (3.8) years; tested via running; conducted in a rural area in the Netherlands)

  • SEM Peak Power boys: 16.2 watts

  • SEM Mean Power boys: 14.2 watts

  • SEM Peak Power girls: 11.1 watts

  • SEM Mean Power girls: 9.9 watts

Minimal Detectable Change (MDC)

Typically developing chidren aged 6-12: (Douma-van Riet et al., 2012)

  • MDC Peak Power: 38.0 watts (calculated from SEM)

  • MDC Mean Power: 33.5 watts (calculated from SEM)

Typically developing children aged 6-18: (Steenman et al., 2016)

  • MDC Peak Power boys: 45 watts (calculated from SEM)

  • MDC Mean Power boys: 39.4 watts (calculated from SEM)

  • MDC Peak Power girls: 30.8 watts (calculated from SEM)

  • MDC Mean Power girls: 27.4 watts (calculated from SEM)

Normative Data

Typically developing boys and girls aged 6-18:

 

Steenman et al., 2016

 

Bongers et al., 2015

 

 

 

Boys (n = 331)

Girls (n = 352)

Boys (n = 28)

Girls (n = 37)

Mean age

12.0

11.8

10.1

9.9

SD (range)

3.8 (6.0-18.7)

3.7 (6.0-18.8)

2.9 (6.5-18.6)

2.8 (6.2-17.1)

Mean MP (W)

389.1

295.8

214

178

SD (range)

261.7 (57.17-1178.0)

185.0 (48.4-785.8)

131 (58-617)

86 (35-372)

Mean PP (W)

441.4

337.9

248

208

SD (range)

294.1 (64.5-1296.8)

207.5 (58.9-838.0)

151 (74-672)

86 (35-372)

Typically developing boys aged 6-12: (Douma-van Riet et al., 2012)

  • Mean (SD) Muscle Power Sprint Test (MPST) Peak Power (PP); 217.4 watts (102.3), range = 64.4-660.8

  • Mean (SD) Muscle Power Sprint Test (MPST) Mean Power (MP); 191.7 watts (91.6), range = 57.2-557.6

Typically developing girls aged 6-12: (Douma-van Riet et al., 2012)

  • Mean (SD) Muscle Power Sprint Test (MPST) Peak Power (PP); 167.8 watts (78.6), range = 48.4-447.0

  • Mean (SD) Muscle Power Sprint Test (MPST) Mean Power (MP); 191.7 watts (91.6), range = 58.9-523.9

Test/Retest Reliability

Typically developing children aged 6-12: (Douma-van Riet et al., 2012)

  • Excellent test-retest reliability for Peak Power (PP) (ICC = 0.98)

  • Excellent test-retest reliability for Mean Power (MP) (ICC = 0.98)

Typically developing children aged 6-18: (Steenman et al., 2016)

  • Excellent test-retest reliability for Mean Power boys (ICC = 0.89)

  • Excellent test-retest reliability for Mean Power girls (ICC = 0.90)

  • Excellent test-retest reliability for Mean Power both (ICC = 0.90)

Interrater/Intrarater Reliability

Typically developing children aged 6-18: (Steenman et al., 2016)

  • Excellent interrater reliability for Mean Power boys (ICC = 0.97)

  • Excellent interrater reliability for Mean Power girls (ICC = 0.96)

  • Excellent interrater reliability for Mean Power both (ICC = 0.97)

Criterion Validity (Predictive/Concurrent)

Concurrent Validity

Typically developing children aged 6-18: (Bongers et al., 2015)

  • Excellent correlation between Peak Power (PP) arm cranking WAnT and MPST (r = .86; p < .001)

  • Excellent correlation between Mean Power (MP) arm cranking WAnT and MPST (r = .91; p < .001)

  • When normalized for body mass, adequate correlation between Peak Power (PP) arm cranking WAnT and MPST (r = .55; p < .001)

  • When normalized for body mass, excellent correlation between Mean Power (MP) arm cranking WAnT and MPST (r = .81; p < .001)

Construct Validity

Convergent Validity

Typically developing children aged 6-18: (Bongers et al., 2015)

  • Excellent correlation between PP MPST and age (r = .90; p < .001)

  • Excellent correlation between MP MPST and age (r = .90; p < .001)

Neuromuscular Conditions

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Standard Error of Measurement (SEM)

Spina Bifida aged 5-18: (Bloemen et al., 2016; n = 38; mean age = 13.6 (3.1) years; wheelchair users with the following lesion levels: thoracic (n = 7); lumbar (n = 41); sacral (n = 5))

  • SEM Peak Power: 6.8 watts

  • SEM Mean Power: 5.4 watts

Minimal Detectable Change (MDC)

Spina Bifida (wheelchair users) aged 5-18: (Bloemen et al., 2016)

  • MDC Peak Power: 18.7 watts

  • MDC Mean Power: 15.0 watts

Normative Data

Spina Bifida (wheelchair users) age 5-18 years: (Bloemen, 2016; n = 53; mean age = 13.6 (3.1) years; based on 4 sprints; see content validity section for further details)

  • Mean (SD) Muscle Power Sprint Test (MPST) Peak Power (PP); 59.2 watts (39.1), range = 5.0-143.4

  • Mean (SD) Muscle Power Sprint Test (MPST) Mean Power (MP); 54.0 watts (36.1), range = 4.1-127.0

Test/Retest Reliability

Spina Bifida (wheelchair users) aged 5-18: (Bloemen et al., 2016)

  • Excellent test-retest reliability for Peak Power (PP) (ICC = 0.98)

  • Excellent test-retest reliability for Mean Power (MP) (ICC = 0.98)

Criterion Validity (Predictive/Concurrent)

Concurrent

Spina Bifida (wheelchair users) age 5-18 years: (Bloemen, 2016; n = 38; mean age = 13.6 (3.1) years)

  • Excellent correlation between Peak Power (PP) arm cranking WAnT and MPST (r = .74; p <.01)

  • Excellent correlation between Mean Power (MP) arm cranking WAnT and MPST (r = .88; p <.01)

Construct Validity

Convergent Validity

Spina Bifida (wheelchair users) age 5-18 years: (Bloemen, 2016)

  • Excellent correlation between 10X5 Meter Sprint Test (MST) and MPST (r = -.70)

  • Excellent correlation between slalom test and MPST (r = -.67)

  • Adequate correlation between One Stroke Push Test (1SPT) and MPST (r = .56)

Content Validity

Spina Bifida (wheelchair users) aged 5-18 years: (Bloemen, 2016)

  • Anaerobic system utility occurs in high intensity maximal effort exercise through 30s. Exercise time for 6 sprints in this population was 42.5±10.3 seconds. The cutoff point for 30 s was 4 sprints. Thus, 4 sprints were used for calculations.

  • Recommendation is to use 4 sprints with this population

Bibliography

Bloemen, M. A., Takken, T., Backx, F. J., Vos, M., Kruitwagen, C. L., de Groot, J. F. (2017). Validity and reliability of skill-related fitness tests for wheelchair-using youth with spina bifida. Archives of Physical Medicine & Rehabilitation 98(6), 1097-1103. Find on PubMed

Bongers, B. C., Werkman, M. S., Blokland, D., Eijsermans, M. J., Van der Torre, P., Bartels, B., Verschuren, O., & Takken, T. (2015). Validity of the pediatric running-based anaerobic sprint test to determine anaerobic performance in healthy children. Pediatric Exercise Science, 27(2), 268-276. Find on PubMed

Douma-van Riet, D., Verschuren, O., Jelsma, D., Kruitwagen, C., Smits-Engelsman, B., Takken, T. (2012). Reference values for the muscle power sprint test in 6- to 12-year-old children. Pediatric Physical Therapy, 24(4), 327-332. Find on PubMed

Steenman, K., Verschuren, O., Rameckers, E., Douma-van Riet, D., Takken, T. (2016). Extended reference values for the muscle power sprint test in 6- to 18-year-old children. Pediatric Physical Therapy 28(1), 78-84. Find on PubMed

Verschuren, O., Bongers, B. C., Obeid, J., Ruyten, T., Takken, T. (2013a). Validity of the muscle power sprint test in ambulatory youth with cerebral palsy. Pediatric Physical Therapy, 25(1), 25-28. Find on PubMed

Verschuren, O., & Takken, T. (2014). “The muscle power sprint test.” Journal of Physiotherapy 60(4), 239. Find on PubMed

Verschuren, O., Takken, T., Ketelaar, M., Gorter, J. W., Helders, P. J. (2007). “Reliability for running tests for measuring agility and anaerobic muscle power in children and adolescents with cerebral palsy.” Pediatric Physical Therapy, 19(2), 108-115. Find on PubMed

Verschuren, O., Zwinkels, M., Obeid, J., Kerkhof, N., Ketelaar, M., Takken, T. (2013b). Reliability and validity of short-term performance tests for wheelchair-using children and adolescents with cerebral palsy. Developmental Medicine & Child Neurology, 55(12), 1129-1135. Find on PubMed