# Assessment of the Brazilian Portuguese Version Selective Control Assessment of the Lower Extremity (SCALE) After Translation and Cross-Cultural Adaptation

## TL;DR

A Portuguese version of a tool to assess lower limb motor control in cerebral palsy patients was successfully translated and validated for use in Brazil.

## Contribution

The SCALE-BR tool was cross-culturally adapted and validated for Brazilian Portuguese, showing strong reliability and correlation with motor function classification.

## Key findings

- SCALE-BR demonstrated excellent internal consistency and intra- and interobserver reliability.
- SCALE-BR showed a strong inverse correlation with the Gross Motor Function Classification System (GMFCS).

## Abstract

What are the main findings?
•The Portuguese version of the Selective Control Assessment of the Lower Extremity (SCALE-BR) was successfully translated, cross-culturally adapted, and validated, proving to be a reproducible and reliable tool.•SCALE-BR showed excellent internal consistency, intra- and interobserver reliability, and a strong, significant inverse correlation with the Gross Motor Function Classification System (GMFCS).

The Portuguese version of the Selective Control Assessment of the Lower Extremity (SCALE-BR) was successfully translated, cross-culturally adapted, and validated, proving to be a reproducible and reliable tool.

SCALE-BR showed excellent internal consistency, intra- and interobserver reliability, and a strong, significant inverse correlation with the Gross Motor Function Classification System (GMFCS).

What are the implications of the main findings?
•SCALE-BR provides a standardized and clinically useful tool for the quantitative assessment of selective motor control in Brazilian patients with spastic cerebral palsy, supporting clinical decision-making and progress monitoring.•This validation confirms selective motor control as a key factor in functional severity and mobility in cerebral palsy patients, which can refine therapeutic intervention selection and enhance understanding of gait.

SCALE-BR provides a standardized and clinically useful tool for the quantitative assessment of selective motor control in Brazilian patients with spastic cerebral palsy, supporting clinical decision-making and progress monitoring.

This validation confirms selective motor control as a key factor in functional severity and mobility in cerebral palsy patients, which can refine therapeutic intervention selection and enhance understanding of gait.

Background/Objectives: This study aims to translate and validate the Selective Control Assessment of the Lower Extremity (SCALE) tool from English into Portuguese. Methods: SCALE was translated into Portuguese independently by two native Portuguese translators and synthesized into a single manuscript: SCALE-BR. Using this test in patients with spastic cerebral palsy, the internal consistency (Cronbach’s α), reliability by intra-class correlation (ICC), and validity compared with the Gross Motor Function Classification System (GMFCS) scores were evaluated. Results: 30 patients diagnosed with spastic cerebral palsy were assessed, with a predominance of males (66.7%), a mean age of 12.9 ± 7.9 (4–38 years) and a majority of diparetic patients (73.3%) and GMFCS I (53.3%). Spearman’s correlation coefficient, R2 = −0.84, p < 0.001, revealed an inverse relationship between the SCALE instrument and the GMFCS, corroborating the findings in the literature. There was an excellent intra- and interobserver agreement (ICC > 0.75). Conclusions: The Portuguese version of the questionnaire was effective, proving to be reproducible and reliable among different evaluators and patients, with an inverse correlation with the GMFCS as expected in the literature.