External validity of the Both Hands Assessment for evaluating bimanual performance in children with bilateral...

Area of Science:

• Pediatric Rehabilitation
• Neuroscience
• Occupational Therapy

Background:

• Bilateral cerebral palsy (CP) significantly impacts bimanual performance and daily activities.
• Accurate assessment of hand function is crucial for effective intervention in children with CP.
• Existing assessments may not fully capture the complexities of bimanual performance in this population.

Purpose of the Study:

• To evaluate the external validity of the Both Hands Assessment (BoHA).
• To determine the relationship between the BoHA and established measures of hand function and self-care skills in children with bilateral CP.

Main Methods:

• A cross-sectional study involving children with bilateral CP (Manual Ability Classification System levels I-III).
• Participants completed the BoHA, alongside established assessments: Bimanual Fine Motor Function (BFMF) classification, Box and Block Test (BBT), Melbourne Assessment 2 (MA2), and Pediatric Evaluation of Disability Inventory (PEDI).

Main Results:

• The BoHA demonstrated high correlations with MACS (ρ=0.89), BFMF (ρ=0.84), and BBT (dominant hand ρ=0.72, non-dominant hand ρ=0.85).
• Correlations with MA2 subscales ranged from 0.48 to 0.83.
• A moderate correlation was found between BoHA and PEDI (ρ=0.51).

Conclusions:

• The BoHA is a valid and reliable tool for assessing bimanual hand function in children with bilateral CP.
• Its strong correlation with other activity-based measures supports its utility in clinical practice.
• The BoHA can inform targeted interventions to improve hand function and participation in daily activities.