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Published on: January 11, 2016
Upper limb activity measures for 5- to 16-year-old children with congenital hemiplegia: a systematic review
Rose Gilmore1, Leanne Sakzewski, Roslyn Boyd
1Brain Research Institute, Melbourne, Victoria, Australia.
Insights
This review identified the best measures for assessing upper limb activity in children with hemiplegia. The Assisting Hand Assessment (AHA) and ABILHAND-Kids show strong psychometric properties for evaluating bimanual and overall function.
Area of Science:
- Pediatric Rehabilitation
- Neuroscience
- Occupational Therapy
Background:
- Congenital hemiplegia significantly impacts upper limb function in children.
- Accurate assessment of upper limb activity is crucial for effective intervention.
- Existing measures vary in validity, reliability, and clinical utility.
Purpose of the Study:
- To systematically review and compare upper limb activity measures for children (5-16 years) with congenital hemiplegia.
- To evaluate measures based on validity, reliability, evaluative validity, and clinical utility.
- To identify the most suitable assessments for clinical practice and research.
Main Methods:
- Systematic search of electronic databases for upper limb activity assessments.
- Inclusion criteria: availability, published validity/reliability data, and relevance to the ICF activity component (≥35%).
- Coding of assessment items according to the International Classification of Functioning, Disability and Health (ICF).
Main Results:
- Thirty-eight measures were identified; five met the inclusion criteria.
- Melbourne Assessment of Unilateral Upper Limb Function (MUUL) is recommended for unimanual capacity.
- Assisting Hand Assessment (AHA) and ABILHAND-Kids demonstrated superior psychometric properties for bimanual activity and overall function, respectively.
Conclusions:
- Multiple measures may be necessary to comprehensively assess unimanual and bimanual upper limb activity.
- The AHA and ABILHAND-Kids are highly recommended for evaluating children with hemiplegia.
- Clinicians should select measures based on specific assessment needs and desired information.
Aim:
This systematic review aimed to compare the validity, reliability, evaluative validity, and clinical utility of upper limb activity measures for children aged 5 to 16 years with congenital hemiplegia.
Method:
Electronic databases were searched to identify assessments that measure upper limb activity available for use and for which published validity and reliability data for the population are obtainable. Assessment items were coded according to the International Classification of Functioning, Disability and Health (ICF) categories to determine if at least 35% of the assessment items fell within the activity component of the ICF. Assessments that met these criteria were included in the review.
Results:
Thirty-eight measures were identified, and five met the inclusion criteria. The best measure of unimanual capacity was the Melbourne Assessment of Unilateral Upper Limb Function (MUUL); however, the Shriners Hospital Upper Extremity Evaluation (SHUEE) and the Quality of Upper Extremity Skills Test (QUEST) could also be considered, depending on the type of information required. The performance-based measure of bimanual upper limb activity in children with hemiplegia with the best psychometric properties was the Assisting Hand Assessment (AHA). The ABILHAND-Kids is a parent-report, performance-based questionnaire with excellent clinical utility and psychometric properties.
Interpretation:
Clinicians may choose to use more than one of these measures to detect changes in unimanual or bimanual upper limb activity.
