Cross-cultural adaptation and psychometric validation of the Greek version of Bimanual Fine Motor Function 2 for children with cerebral palsy.

Abstract

Purpose: To translate and culturally adapt the Bimanual Fine Motor Function 2 (BFMF-2) for use in Greece and assess its psychometric properties, focusing on interrater reliability and construct validity.

Methods: Translation and Cultural Adaptation: Conducted in six stages: forward-translation, synthesis, back-translation, expert committee review, pretesting, and final submission. Psychometric Validation: Assessed interrater reliability among a paediatric neurologist, physiotherapist, occupational therapist, and a parent per child. Convergent construct validity was evaluated using the Greek (Mini-)Manual Ability Classification System (MACS-GR).

Results: Translation and Cultural Adaptation: The process resulted in the development of the Greek BFMF-2 (BFMF-2-GR). Psychometric Validation: Included 62 children with cerebral palsy (CP) aged 3-8 years (mean age 6.2). The overall interrater reliability among four raters was excellent, with an intraclass correlation coefficient up to 0.95. Pairwise interrater reliability ranged from substantial to almost perfect, with Cohen's weighted kappa coefficient from 0.74 to 0.96. Convergent construct validity showed a positive correlation between the BFMF-2-GR and the (Mini-)MACS-GR, with Spearman's ρ from 0.89 to 0.94.

Conclusions: The BFMF-2-GR is a clear, practical, reliable, and valid tool for classifying the fine motor capacity of children with CP in Greece, specifically their ability to grasp, hold, and manipulate objects with each hand separately.