Reliability of the Revised Motor Learning Strategies Rating Instrument and Its Role in Describing the Motor Learning Strategy Content of Physiotherapy Sessions in Paediatric Acquired Brain Injury

Purpose: Documenting the use of motor learning strategies (MLS) in physiotherapy is a foundational step in understanding the effectiveness of motor skills-based treatments in paediatric acquired brain injury (ABI). The purpose of this study was to estimate the inter- and intrarater reliability of the revised Motor Learning Strategies Rating Instrument (MLSRI-22) in physiotherapy for children and youth with ABI when administered by trained student physiotherapists. The MLSRI-22 was then used to describe the MLS content of traditional and robotic treadmill training physiotherapy sessions for children with ABI to demonstrate its application. Method: Thirty videos of children with ABI receiving Lokomat or traditional physiotherapy were rated using the MLSRI-22. Inter- and intrarater reliability were estimated using intra-class correlation coefficients (ICCs). Mean MLSRI-22 item scores described the MLS session content. Results: MLSRI-22 total score inter- and intrarater ICCs were 0.81 (95% CI: 0.61, 0.91) and 0.95 (95% CI: 0.90, 0.98), respectively. There were similarities and differences in MLS content between treatment approaches. Conclusions: Trained assessors can reliably administer the MLSRI-22 in physiotherapy for children with ABI. Research using MLSRI-22 scores to explore and systematically compare MLS across treatment approaches may provide insight into their effectiveness and contribute to MLS practice guidelines for children with ABI.