Selective Control Assessment of the Lower Extremity (SCALE) measures:

• A. Measures gross motor function in the lower extremities
• B. Assesses balance during gait in kids
• C. Measures selective voluntary motor control of the lower extremities; ALL GMFCS levels if they have spastic CP
• D. Evaluates sensory integration during movement

Answer: (C)

The main idea is assessing selective voluntary motor control in the lower extremities. SCALE specifically looks at the ability to isolate movements at different joints (hip, knee, ankle, toes) without unwanted coupled or synergistic activation of other muscles. This is a common challenge in spastic cerebral palsy, where motor control is not just about strength or how well you can move, but about how precisely you can recruit muscles to perform a single, isolated movement. SCALE provides a way to rate how well someone can perform those isolated movements across lower-extremity joints, and it’s applicable across GMFCS levels when spastic CP is present because SVMC impairment can occur at any functional level.

It’s not a broad measure of gross motor function, so it doesn’t substitute for tools that rate overall mobility or functional tasks. It also doesn’t evaluate balance during gait, nor does it assess sensory processing or integration. Those domains are addressed by other assessments. So the SCALE’s purpose is to quantify selective voluntary motor control of the lower extremities, informing targeted therapies that aim to improve isolated joint control.