{"title":"Validation of the Croatian Visual Function Classification System and subtype-specific differences in cerebral palsy.","authors":"Ana Katušić, Sonja Alimović, Andrea Paulik","doi":"10.1097/MRR.0000000000000680","DOIUrl":null,"url":null,"abstract":"<p><p>The Visual Function Classification System (VFCS) provides a standardised framework for grading visual functioning in children with cerebral palsy (CP). This study evaluated the reliability and construct validity of the Croatian VFCS, and its ability to distinguish visual functioning across CP subtypes and functional classifications. Ninety-five children with CP (mean age: 11.8 years, range: 4-18) were assessed using VFCS, Gross Motor Function Classification System (GMFCS), Manual Ability Classification System (MACS), and Communication Function Classification System (CFCS). Reliability was tested using quadratic weighted kappa and intraclass correlation coefficients (ICCs); differences across CP types with the Kruskal-Wallis, and construct validity with Spearman correlations. The Croatian VFCS showed excellent interrater (κ = 0.87) and intrarater reliability (κ = 0.92), with ICCs greater than 0.90. VFCS levels differed significantly by CP subtype (χ² = 8.30, P = 0.016), with preliminary evidence suggesting that unilateral spastic CP may be associated with better visual function than bilateral spastic or dyskinetic CP. Moderate correlations with CFCS (ρ = 0.557), MACS (ρ = 0.392), and GMFCS (ρ = 0.308) revealed clinically relevant divergences between visual and motor abilities. The Croatian VFCS is a reliable, valid, and clinically sensitive tool. This study provides preliminary evidence of its discriminative utility across CP subtypes and supports integrating VFCS into multidisciplinary assessment and individualised rehabilitation planning.</p>","PeriodicalId":14301,"journal":{"name":"International Journal of Rehabilitation Research","volume":" ","pages":""},"PeriodicalIF":1.3000,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Rehabilitation Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/MRR.0000000000000680","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"REHABILITATION","Score":null,"Total":0}
引用次数: 0
Abstract
The Visual Function Classification System (VFCS) provides a standardised framework for grading visual functioning in children with cerebral palsy (CP). This study evaluated the reliability and construct validity of the Croatian VFCS, and its ability to distinguish visual functioning across CP subtypes and functional classifications. Ninety-five children with CP (mean age: 11.8 years, range: 4-18) were assessed using VFCS, Gross Motor Function Classification System (GMFCS), Manual Ability Classification System (MACS), and Communication Function Classification System (CFCS). Reliability was tested using quadratic weighted kappa and intraclass correlation coefficients (ICCs); differences across CP types with the Kruskal-Wallis, and construct validity with Spearman correlations. The Croatian VFCS showed excellent interrater (κ = 0.87) and intrarater reliability (κ = 0.92), with ICCs greater than 0.90. VFCS levels differed significantly by CP subtype (χ² = 8.30, P = 0.016), with preliminary evidence suggesting that unilateral spastic CP may be associated with better visual function than bilateral spastic or dyskinetic CP. Moderate correlations with CFCS (ρ = 0.557), MACS (ρ = 0.392), and GMFCS (ρ = 0.308) revealed clinically relevant divergences between visual and motor abilities. The Croatian VFCS is a reliable, valid, and clinically sensitive tool. This study provides preliminary evidence of its discriminative utility across CP subtypes and supports integrating VFCS into multidisciplinary assessment and individualised rehabilitation planning.
期刊介绍:
International Journal of Rehabilitation Research is a quarterly, peer-reviewed, interdisciplinary forum for the publication of research into functioning, disability and contextual factors experienced by persons of all ages in both developed and developing societies. The wealth of information offered makes the journal a valuable resource for researchers, practitioners, and administrators in such fields as rehabilitation medicine, outcome measurement nursing, social and vocational rehabilitation/case management, return to work, special education, social policy, social work and social welfare, sociology, psychology, psychiatry assistive technology and environmental factors/disability. Areas of interest include functioning and disablement throughout the life cycle; rehabilitation programmes for persons with physical, sensory, mental and developmental disabilities; measurement of functioning and disability; special education and vocational rehabilitation; equipment access and transportation; information technology; independent living; consumer, legal, economic and sociopolitical aspects of functioning, disability and contextual factors.