A study validating the Italian version of the Level of Sitting Scale in children with cerebral palsy

Objectives: To assess measurement properties of the Italian version of the Level of Sitting Scale when classifying sitting ability of children with cerebral palsy. Design: Methodological study. Setting: Children’s hospital (inpatients and outpatients). Subjects: Children 18 years of age or younger with cerebral palsy. Methods: The original English version of the Level of Sitting Scale was translated and culturally adapted for the Italian culture following international guidelines. Examination of reliability and validity of the Italian Level of Sitting Scale was then undertaken. Inter-rater and one-week test–retest reliability were estimated using both intraclass correlation coefficients (ICCs) with 95% confidence intervals and Bland–Altman plots. Construct validity of the Italian Level of Sitting was evaluated using three approaches examining Pearson’s correlation coefficient (r) and Mann–Whitney U test (P-value < 0.05). Main measures: Italian Level of Sitting Scale and Gross Motor Function Classification System. Results: The Italian Level of Sitting Scale was administered to 109 subjects. Inter-rater reliability and one-week test–retest showed excellent value with ICCs of 0.99 for both. (1) The Pearson correlation coefficient comparing Italian Level of Sitting Scale with Gross Motor Function Classification System was −0.91 and (2) correlation with total amount of adaptive seating components was −0.90. Differences in sitting abilities and use/non-use of wheelchair were found. All reported a statistical significance of P < 0.01. Conclusion: Our findings provide evidence of reliability and validity when using the Italian Level of Sitting Scale to classify seated postural abilities in a sample of Italian children with cerebral palsy.