Sonja Mensch

125 The relationship between motor abilities and quality of life position scores of Movakic for each child are based on the scores of these relevant situations and thus can differ per child. Therefore, the resultant score of motor abilities does not express the motor abilities in general. On the other hand, the theoretical framework of Movakic was based on the fact that instruments measuring general motor abilities are not relevant and applicable to children with SMD (Mensch et al. 2015c). So, there simply is no instrument that measures general motor abilities in this population and it is infeasible to create such an instrument because of the characteristics and heterogeneity of these children. Based on the knowledge that so many variables could influence QoL, positively or negatively, we would like to urge health professionals to apply every bit of solid evidence to make the lives of these children more pleasant. More specifically, based on the results of this studywe recommendphysical therapists to invest in their interventions focussed on stimulating and activating children with SMD with the aim of increasing their motor abilities. Parents and care-givers play an important role in the success of this intervention. Therefore, after completing Movakic, we recommend involving parents and caregivers. Discussing the scores per item will help them in better understanding the need for investing their time in stimulating motor abilities and in achieving goals in the domain of motor abilities. Inthisfirst study inchildrenwithSMDweonlystudiedcross-sectional relationships andnot longitudinal relationships. A longitudinal study design is recommended to judge the influence of changes in motor abilities on QoL. A Randomised Controlled Trial (RCT) with a large study population and a long period of intervention, aimed at improving motor abilities, is recommended. An earlier study on the responsiveness and validity of Movakic showed the importance and multitude of life events that children with SMD have to deal with (Mensch et al. 2016). Therefore, the relationship between carefully inventoried events such as change in medication, disease, surgery and interventions and its influence on QoL should be considered in future studies in this severely disabled group of children. CONCLUSION This study shows that motor abilities in children with severe multiple disabilities are related to quality of life. Better motor abilities were moderately associated with higher QoL levels, indicating the importance of motor abilities, even in this severely disabled group of children.