The inter-rater agreement of the prioritized problems is good enough for client-centred occupational therapy. The reproducibility of the performance and satisfaction scores is moderate. The results support the construct and criterion validity. The COPM identifies many child-unique problems that are not assessed with existing standardized measurement instruments or with a simple open-ended question.
Ad-AHA Assisting Hand Assessment for adolescents AHA Assisting Hand Assessment DIF Differential item functioning AIM To develop and evaluate a test activity from which bimanual performance in adolescents with unilateral cerebral palsy (CP) can be observed and scored with the Assisting Hand Assessment (AHA), and to evaluate the construct validity of the AHA test items for the extended age range 18 months to 18 years. METHOD A new test activity was developed and evaluated for its ability to elicit bimanual actions in adolescents with (n=20) and without (n=10) unilateral CP. The AHA scores of 126 adolescents (mean age 14y 3mo, SD 2y 6mo; 71 males, 55 females) and 157 children with unilateral CP (mean age 6y 1mo, SD 2y 10mo; 102 males, 55 females) were analysed using the Rasch measurement model. RESULTS The test activity elicited bimanual actions in 100% of typically developing adolescents and in 96.8% and 57.9% of adolescents with unilateral CP (moderately and severely limited hand function respectively). The scale demonstrated good construct validity; thus the same scoring criteria can be used for the age range studied. INTERPRETATION The new Assisting Hand Assessment for adolescents (Ad-AHA) activity is valid for use with 13-to 18-year-olds to elicit bimanual performance in adolescents with unilateral CP. The same AHA scoring criteria can be used both for children and for adolescents within the age range 18 months to 18 years. Unilateral cerebral palsy (CP) is characterized by motor impairments on one side of the body, and the hand impairments in particular contribute to functional limitations. Current rehabilitation efforts predominantly aim to improve bimanual performance, but this requires valid and reliable performance-based instruments for evaluating the hand function of people of different ages with unilateral CP. The Assisting Hand Assessment (AHA), which was introduced in 2003, has proved to be a valid performance-based instrument for children with CP. The AHA measures and describes how effectively children with unilateral disability use their affected hand to perform tasks requiring the use of both hands. This is in contrast to other tests in which people are asked to specifically use the affected hand, so that their best performance with that hand can be assessed. The AHA has been validated for children with unilateral CP aged 18 months to 12 years (Kids-AHA) and is sufficiently sensitive to monitor changes over time.
AHA Assisting Hand AssessmentAIM The aim of this study was to determine the immediate effect of wearing a wrist and thumb brace on the performance of bimanual activities in children with spastic hemiplegic cerebral palsy.METHOD In a pre-and post-test cohort study of 25 children (age range 4-11y; mean age 8y 4mo[SD 2y 2mo]; 16 males, 9 females) with spastic hemiplegic cerebral palsy with a Zancolli classification hand score of I, IIA, or IIB (mild and moderate hand dysfunction; children with a Zancolli classification of III -severe hand dysfunction -were excluded from this study), performance of bimanual activities was evaluated with the Assisting Hand Assessment (AHA) on three occasions: one assessment with a static wrist and thumb brace placed on the affected hand and two other assessments without a brace. The differences between AHA scores obtained at the three assessments were evaluated using the repeated measures analysis of variance.RESULTS Performance of bimanual activities while wearing the brace improved significantly compared to performance without the brace (p<0.001). With the brace, the mean AHA score increased by 3.2 (95% confidence interval 2.1-4.3) from 59.1 to 62.3. The scores of the two assessments without the brace did not differ significantly.
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