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This scale was previously modified for use in a research setting but contains the same 20 gross motor function items as the original clinical scale (complete protocol available at [28][29] Degree of innervation by the ulnar nerve in the hypothenar muscle group of the hand was estimated using maximum ulnar CMAP amplitude (complete CMAP protocol available at In children five years and older, myometry measurements were performed three times for right and left elbow flexion, and for right and left knee extension, at each visit using the Lafayette Instrument MMT System Model 01163 myometer with a positioning method as previously described