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Author Spotlight: Enhancing Upper Limb Rehabilitation in Stroke Patients Through Advanced Robotic and Neuromodulation Technologies
Published on: October 11, 2024
An Initial Psychometric Evaluation of a Novel Upper Extremity Pediatric Stroke Hemiplegic Motor Impairment Scale
Laura A Malone1, Nicole Andrejow2, Erin C Naber2
1Kennedy Krieger Institute, Baltimore, Maryland; Department of Neurology, Johns Hopkins Medicine, Baltimore, Maryland; Department of Physical Medicine and Rehabilitation, Johns Hopkins Medicine, Baltimore, Maryland.
Insights
The Pediatric Stroke Hemiplegic Motor Impairment Scale-Upper Extremity (Pedi HEMIs-UE) shows excellent reliability and validity for assessing motor skills in children with hemiparesis after stroke. This innovative tool aids in evaluating upper limb function in pediatric stroke survivors.
Area of Science:
- Pediatric neurology
- Rehabilitation medicine
- Motor control research
Background:
- Pediatric stroke often results in hemiparesis, impacting motor function.
- Accurate assessment of motor impairment is crucial for effective rehabilitation.
- Existing measures may not fully capture the nuances of upper extremity hemiplegia in children.
Purpose of the Study:
- To introduce the Pediatric Stroke Hemiplegic Motor Impairment Scale-Upper Extremity (Pedi HEMIs-UE).
- To evaluate the initial psychometric properties of the Pedi HEMIs-UE.
- To understand current practices in assessing pediatric stroke motor impairment.
Main Methods:
- Cross-sectional study design.
- Administration of the Pedi HEMIs-UE and other assessments to pediatric participants.
- Statistical analysis including Cronbach's alpha for internal consistency, ICC for inter-rater reliability, and correlation analyses for concurrent validity.
Main Results:
- The Pedi HEMIs-UE demonstrated excellent internal consistency (Cronbach's α = 0.91).
- Inter-rater reliability was excellent (ICC = 0.91), indicating high agreement between raters.
- Strong concurrent validity was shown through high correlation with the Assisting Hand Assessment (AHA)/mini-AHA (r = -0.938).
Conclusions:
- The Pedi HEMIs-UE is a feasible, reliable, and valid measure for assessing upper extremity motor impairment in youth post-stroke.
- These findings support the use of the Pedi HEMIs-UE in clinical and research settings for pediatric hemiparesis.
- The scale offers a promising tool for evaluating functional recovery in children with hemiplegic cerebral palsy due to stroke.
Background:
Our team designed an innovative, observation-based motor impairment measure-the Pediatric Stroke Hemiplegic Motor Impairment Scale (Pedi HEMIs). Here we present the results of a survey describing common practices in the pediatric stroke community and the initial psychometric properties of the upper extremity subscale of the Pedi HEMIs (Pedi HEMIs-UE).
Methods:
This is a cross-sectional study whereby participants completed a battery of assessments including the novel Pedi HEMIs-UE. Internal consistency was measured via Cronbach alpha (α). Intraclass correlation (ICC) was used to assess inter-rater reliability (IRR). Concurrent validity was investigated using Pearson or polychoric correlations and simple linear regressions.
Results:
The study sample consisted of 18 children aged 1.08 to 15 years. Two participants completed two sets of evaluations, totaling 20 data sets. Cronbach α, a measure of internal consistency, was on average 0.91 (range: 0.89 to 0.92). IRR was excellent with the six raters in almost perfect agreement (ICC = 0.91; 95% confidence interval [CI]: 0.83 to 0.96). Pearson correlation coefficient between the Pedi HEMIs-UE and logit Assisting Hand Assessment (AHA)/mini-AHA was -0.938 (95% CI: -0.979 to -0.827, P < 0.001), indicating excellent concurrent validity.
Conclusions:
We found excellent feasibility, reliability, and validity of the Pedi HEMIs-UE in a convenience sample of youth with hemiparesis after stroke.
