EDITOR’S CHOICE The Cerebral Palsy Profile of Health and Function: Upper-Extremity Domain’s Sensitivity to Change Following Musculoskeletal Surgery Namrata Grampurohit, PhD, * Mary Slavin, PhD,‡ Pengsheng Ni, MPH, MD,‡ Scott Kozin, MD,† Alan Jette, PhD,§ MaryJane Mulcahey, PhD*† Purpose The Cerebral Palsy Profile of Health and Function (CP-PRO) Computerized Adaptive Tests (CAT) are quality of life measures developed specifically for use in children with cerebral palsy. This study examined the ability of the upper-extremity (UE) CP-PRO CAT to detect change in function after UE surgery compared with the Pediatric Outcomes Data Collection Instrument (PODCI), ABILHAND-Kids, and Box and Blocks test. Methods From 2009 to 2013, children with cerebral palsy who had UE musculoskeletal surgery completed the UE CP-PRO CAT, PODCI-UE, ABILHAND-Kids, and Box and Blocks tests before surgery (97 children) and at 3 postoperative intervals: 6 months (80 children), 12 months (73 children), and 24 months (52 children). Mean, SD, effect size (ES), and standardized response mean (SRM) values for each measure at each time interval and each level of the Manual Ability Classification System were calculated and compared. Finally, the minimal detectable change at the 90% confidence level was determined. Results Values for the ES (0.40) and SRM (0.53) for the UE CP-PRO CAT at baseline to 6 months were moderate and significantly greater than the PODCI-UE (ES, 0.18; SRM, 0.25). The ES and SRM for the PODCI-UE, ABILHAND-Kids, and Box and Blocks tests were not significantly greater than for the UE CP-PRO CAT at any period. From baseline to 6 months, the UE CP-PRO CAT detected a large and significant improvement for Manual Ability Classification System level II (SRM, 0.70; ES, 0.70). The minimal detectable change for the UE CP-PRO CAT was 5.20. Conclusions The UE CP-PRO CAT is significantly better in detecting change in UE function in the first 6 months after surgery and is comparable to other measures at 12 and 24 months. (J Hand Surg Am. 2019;-(-):-e-. Copyright Ó 2018 by the American Society for Sur- gery of the Hand. All rights reserved.) Type of study/level of evidence Diagnostic II. Key words Cerebral palsy, functional measure, upper extremity. From the *Department of Occupational Therapy, College of Rehabilitation Sciences, Thomas Jefferson University; and the †Shriners Hospitals for Children, Philadelphia, PA; and the ‡Department of Health Law, Policy, and Management, Boston University School of Public Health; and the §Department of Rehabilitation Science, MGH Institute of Health Professions, Boston, MA. Received for publication May 6, 2018; accepted in revised form December 7, 2018. No benefits in any form have been received or will be received related directly or indirectly to the subject of this article. Corresponding author: Namrata Grampurohit, PhD, Department of Occupational Therapy, College of Rehabilitation Sciences, Thomas Jefferson University, 901 Walnut Street, Suite #600, Philadelphia, PA 19107; e-mail: namrata.grampurohit@jefferson.edu. 0363-5023/19/---0001$36.00/0 https://doi.org/10.1016/j.jhsa.2018.12.007 Ó 2018 ASSH r Published by Elsevier, Inc. All rights reserved. r 1