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The Motor Learning Strategy Instrument: Interrater Reliability Within Usual and Virtual Reality Physical Therapy Interventions

Levac, Danielle PhD; Missiuna, Cheryl PhD; Wishart, Laurie PhD; DeMatteo, Carol MSc; Wright, Virginia PhD

doi: 10.1097/PEP.0b013e3182750c28
Research Article

Purpose: To evaluate and compare the interrater reliability of the Motor Learning Strategy Rating Instrument (MLSRI) within usual and virtual reality (VR) interventions for children with acquired brain injury.

Methods: Two intervention sessions for each of 11 children (total, 22) were videotaped; sessions were provided by 4 physical therapists. Videotapes were divided into usual and VR components and rated by 2 observers using the MLSRI. A generalizability theory approach was used to determine interrater reliability for each intervention.

Results: Interrater reliability for usual interventions was high for the MLSRI total score (g-coefficient, 0.81), whereas it was low for the VR total score (g-coefficient, 0.28); MLSRI category g-coefficients varied from 0.35 to 0.65 for usual and from 0.17 to 0.72 for VR interventions.

Conclusion: Adequate reliability was achieved within ratings of usual interventions; however, challenges related to MLSRI use to rate VR-based interventions require further evaluation.

The authors report that their instrument shows good interrater reliability when assessing usual interventions but was less reliable when assessing virtual reality based therapy.

School of Rehabilitation Science (Drs Levac, Missiuna, Wishart, and Wright and Ms DeMatteo) and CanChild Centre for Childhood Disability Research (Drs Missiuna and Wright and Ms DeMatteo), McMaster University, Hamilton, Ontario, Canada; Bloorview Research Institute (Dr Wright), Toronto, Ontario, Canada; Department of Physical Therapy (Dr Wright), University of Toronto, Toronto, Ontario, Canada.

Danielle Levac, PhD, School of Rehabilitation Science, Institute for Applied Health Science, Room 403, McMaster University, 1400 Main St W, Hamilton, Ontario, Canada, L8S 1C7 (

Grant Support: The first author was supported by a doctoral award from the Canadian Child Health Clinician Scientist Program, a strategic training initiative of the Canadian Institutes of Health Research, and the McMaster Child Health Research Institute. Dr Missiuna holds a Rehabilitation Scientist award from the Ontario Ministry of Health and Long-Term Care and the Ontario Neurotrauma Foundation. Funding for this study was provided by a grant from the Physiotherapy Foundation of Canada.

The authors declare no conflict of interest.

© 2013 Lippincott Williams & Wilkins, Inc.