Selecting assessment tools to characterize upper limb function of children with cerebral palsy: A mega-review of
Leonardo Vinícius Thomé Teixeira da Silva1, Milena Vegas2, Natalia Aquaroni Ricci1
1Master's and Doctoral Program in Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil.
Insights
This mega-review identified the ABILHAND-Kids, AHA, and MUUL as top tools for assessing upper limb function in children with cerebral palsy (CP). These tools effectively evaluate children aged 6-12 with unilateral CP.
Area of Science:
- Pediatric Rehabilitation
- Neuroscience
- Biomedical Engineering
Background:
- Cerebral Palsy (CP) significantly impacts upper limb (UL) function in children.
- A comprehensive understanding of available assessment tools for UL function in children with CP is lacking.
- Existing systematic reviews vary in scope and quality, necessitating a consolidated overview.
Purpose of the Study:
- To conduct a mega-review of published systematic reviews to identify and summarize assessment tools for UL function in children with CP.
- To evaluate the methodological quality and measurement properties of identified assessment tools.
- To determine the most suitable tools for evaluating UL function in specific pediatric CP populations.
Main Methods:
- A systematic search strategy identified 12 relevant systematic reviews for the mega-review.
- Included reviews underwent descriptive analysis of methodology and measurement properties.
- Methodological quality was assessed using AMSTAR-2; measurement properties and International Classification of Functioning, Disability and Health (ICF) domain coverage were synthesized.
Main Results:
- Eighty-four distinct assessment tools were identified across the 12 systematic reviews.
- The methodological quality of the systematic reviews ranged from critically low to moderate.
- Assessment tools covered ICF domains including body structure/function and activities/participation, with a focus on reliability and validity.
Conclusions:
- The ABILHAND-Kids, Assisting Hand Assessment (AHA), and Melbourne Assessment of Unilateral Upper Limb Function (MUUL) are recommended for evaluating children aged 6-12 with unilateral CP.
- These tools demonstrate suitability based on synthesized measurement properties and ICF domain coverage.
- Further research may refine the selection and application of UL assessment tools in pediatric CP.
Aim:
A mega-review of published systematic reviews without restriction on year of publication was implemented to summarize available assessment tools of upper limb (UL) function in children with Cerebral Palsy (CP).
Method:
A multi-prong search strategy was used to identify 12 systematic literature reviews for inclusion in the mega-review. Included reviews were coded by descriptive analyses, which included methodological and reported measurement property description. Methodological quality of the selected systematic reviews was evaluated with the AMSTAR-2. We synthetized the measurement properties of the revised assessment tools and their coverage within the International Classification of Functioning, Disability and Health (ICF) domains.
Results:
The 12 systematic reviews addressed 84 assessment tools. Systematic reviews' methodological quality varied between critically low to moderate. Suggested assessment tools covered ICF domains of body structure and function, and activities and participation. Measurement property data analysis was based mostly on reliability and validity.
Interpretation:
Based on the findings of the mega-review, the ABILHAND-Kids, Assisting Hand Assessment (AHA) and Melbourne Assessment of Unilateral Upper Limb Function (MUUL) are the most suitable tools to evaluate children between 6 and 12 years of age with unilateral CP.
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