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The Neurological Hand Deformity Classification: Construct validity, test-retest, and inter-rater reliability.

Simon Garbellini1, Melinda Randall2, Michael Steele3

  • 1School of Allied Health, Australian Catholic University, Melbourne, VIC, Australia; Department of Pediatric Rehabilitation, Perth Children's Hospital, Perth, WA, Australia.

Journal of Hand Therapy : Official Journal of the American Society of Hand Therapists
|May 20, 2021
PubMed
Summary

The Neurological Hand Deformity Classification (NHDC) tool shows good reliability and validity for assessing hand deformities in children with cerebral palsy. This supports its use in clinical practice for classifying flexion and extension impairments.

Keywords:
Cerebral palsyClassificationHand deformitiesPsychometrics

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Area of Science:

  • Neurology
  • Pediatrics
  • Rehabilitation Medicine

Background:

  • The Neurological Hand Deformity Classification (NHDC) is an impairment-based tool for classifying hand deformities into flexion or extension types.
  • Classification is based on live observation or video footage, differentiating levels by wrist position and movement.

Purpose of the Study:

  • To examine the validity and reliability of the NHDC tool.
  • To assess the NHDC's effectiveness in classifying hand deformities in children with cerebral palsy.

Main Methods:

  • A measurement study design was employed.
  • Data from 127 children with cerebral palsy (ages 8 months to 15 years) were analyzed.
  • Construct validity was assessed using correlation coefficients, while test-retest and inter-rater reliability were evaluated using kappa statistics.

Main Results:

  • Construct validity hypotheses were met in most correlations with body structure and activity measures.
  • Test-retest reliability for flexion and extension deformities was good to excellent (κw = 0.84, κ = 1.0).
  • Inter-rater reliability was moderate to excellent for both flexion (κw = 0.76) and extension (κ = 0.75) deformities.

Conclusions:

  • The NHDC demonstrates expected relationships with other measures, indicating good construct validity.
  • The tool exhibits stability across repeated measures and acceptable agreement between raters.
  • These findings support confidence in using the NHDC for classifying hand deformities in children with cerebral palsy.