Hand-Use-at-Home Questionnaire: validity and reliability in children with neonatal brachial plexus palsy or unilateral cerebral palsy.
Menno van der Holst, Yvonne Geerdink, Pauline Aarts and 5 others
PMID 29756465WHAT IT FOUND
Parents can use the Hand-Use-at-Home questionnaire to report how often a child with one weak arm spontaneously uses it at home.
Scores were stable over two to four weeks and related to severity, but ability alone did not fully predict use.
Key findings
01Parents' repeated Hand-Use-at-Home scores two to four weeks apart were stable, with an ICC of 0.89.
02In neonatal brachial plexus palsy, greater lesion extent was associated with lower Hand-Use-at-Home scores.
03In unilateral cerebral palsy, children at Manual Ability Classification System level III had lower Hand-Use-at-Home scores than children at level I or II.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The sample was a convenience sample, so it may not represent all children with these conditions. The neonatal brachial plexus palsy group was mixed in lesion extent and treatment history, which could affect scores. The unilateral cerebral palsy group had more children at Manual Ability Classification System level III than expected, which could lower scores. There was no gold standard for spontaneous hand use, so the questionnaire was compared only with other measures. Seven children had Pediatric Outcome Data Collection Instrument scores that could not be calculated because parents said the child was too young for some items. The mini version of the Children's Hand-Use Experience Questionnaire used for younger children had not been validated, so results were reported as raw percentages. The secondary surgery group had only four children, so it could not explain hand use. The study measured hand use at one point in time, so it did not show whether scores change after therapy. Ability scores did not fully explain spontaneous hand use, so other factors such as developmental disregard may matter.
Declared interests
The authors declared no potential conflicts of interest and received no financial support for the research, authorship, or publication of the article.
The easy way to misread this
Do not assume a small Hand-Use-at-Home score change after therapy is real. The test-retest data showed that an individual child's score must change by more than 1.66 logits to be beyond measurement error.