Cultural adaptation and reliability assessment of the Hammersmith neonatal neurological examination for Brazilian newborns at risk of cerebral palsy

Abstract

Background Reliable instruments that lead to early diagnosis for CP are extremely important so that these children are referred for early stimulation, benefiting their development. Objective To perform a cross-cultural adaptation and reliability assessment of a Brazilian version of the Hammersmith Neonatal Neurological Examination (HNNE), expanded and summarized. Methods A methodological, cross-sectional, nonexperimental quantitative analysis was conducted in two phases as follows: cultural adaptation of the HNNE, expanded and summarized, and reliability assessment of the Brazilian version of the HNNE. Phase one was developed in five stages (initial translation, synthesis of the translation, a committee of experts, backtranslation, and submission to the author), with the semantic questions, content, and face validity being evaluated. Phase two included 143 newborns and we analyzed the internal consistency, stability, and equivalence (intra- and interexaminer) of the instrument. Internal consistency was calculated using Cronbach's alpha, and intra- and interexaminer reliability and reproducibility assessed through test-retest were calculated using the intraclass correlation coefficient Results Although internal consistency, assessed using Cronbach's alpha, showed unsatisfactory results, the results of inter-and intraexaminer equivalence showed a high agreement between the evaluations in all domains. The test-retest also showed excellent agreement between the domains. Conclusions The Brazilian HNNE expanded and summarized versions can be considered to be adapted and reliable for the neurological assessment of Brazilian newborns to identify changes in neurological development and early referral to the stimulation or early rehabilitation units and as a promising option to be used in the context of primary care in Brazil.

Translation and measurement properties of the Portuguese-Brazil version of the Hammersmith Infant Neurological Examination (HINE-Br)

“…25 Despite the several available HINE Recording & Scoring Proforma, few studies have described the translation process. 14 , 27 The guidelines are important to ensure that, despite the necessary changes, the translation is faithful and similar to the original version of the instrument. 22 , 23 The translation process of the HINE-Br followed the recommendations of internationally recognized guidelines, 22 , 23 and was carried out by experienced professionals and by the developer of the instrument.…”

“…Recently, the translation of one of the versions of the HINE, the Hammersmith Neonatal Neurological Examination (HNNE), was published, which is intended only for the assessment of newborns up to the first month of age. 14 Consequently, the translation of the HINE into Brazilian Portuguese will allow the expansion of early detection of CP in infants up to 24 months of age. Thus, the objectives of the current study were: To translate the HINE into Brazilian Portuguese (HINE-Br) and To analyze the reliability of the HINE-Br in the population of Brazilian infants.…”

“…10 In addition, LMICs, like Brazil, present uncertain epidemiological data on Brazilian children with CP and the use of standardized clinical tools in the diagnosis of this health condition is still poorly studied. [14][15][16] One of the tools used to early diagnose CP in LMICs specifically is the NMR; however it is not accessible to the majority of the population, and there is a lack of information on how CP diagnosis is performed in the clinical practice of Brazilian services. The absence of standardized and valid tools available in Portuguese and adapted for the Brazilian population with CP, as well as the absence of Brazilian guidelines, may contribute to the failure of early detection of CP in the country and the lack of epidemiological data.…”

Core sets no Transtorno do Espectro Autismo (TEA) - Proposta de instrumentos segundo a visão do fisioterapeuta

“…Esses itens podem ser adicionados a avaliação clínica e tam-bém podem ser realizados através de instrumentos padronizados, como Escala de equilíbrio pediátrica (EEP) (Ries et al, 2012) e Avaliação Neurológica Neonatal de Hammersmith (HINNE) (Correr;Pfeifer, 2023), já que são instrumentos que abrangem esses códigos.…”