A systematic review of upper limb activity measures for 5‐ to 18‐year‐old children with bilateral cerebral palsy

Abstract

Aim To investigate measurement properties and feasibility of upper limb activity measures in children aged 5–18 years with bilateral cerebral palsy (CP). Methods Five electronic databases were searched to identify measures of upper limb activity with published psychometric data for children with bilateral CP aged 5–18 years. Measures included both Patient‐Reported Outcome Measures (PROMs) and observational measures. The COnsensus‐based Standards for selection of health Measurement Instruments checklist was used to evaluate methodological quality of studies for each measure. Results Forty‐eight measures were identified, eight of which met inclusion criteria for reliability and validity. Four PROMs were included: the ABILHAND‐Kids and Children’s Arm Rehabilitation Measure are parent questionnaires measuring overall manual ability; the ACTIVLIM‐CP is a parent questionnaire measuring global activity (upper and lower extremity) performance, and, the Pediatric Upper Limb Measure, Short Form is a child self‐report questionnaire. Four observational measures were included: the Both Hands Assessment (BoHA) is an observational measure of bimanual activity performance; the Melbourne Assessment of Unilateral Upper Limb Function and the Melbourne Assessment 2 measure quality of movement of each upper limb separately, and the Peabody Developmental Motor Scales‐Second Edition assesses fine motor skill capacity in young children. Based upon available evidence, the most suitable PROM for evaluation of upper limb activity in children with bilateral CP is the ACTIVLIM‐CP, and the most suitable observational measure is the BoHA. Conclusion Selection of upper limb measures depend on clinical information required and available resources. The BoHA is the only observational‐based assessment which measures bimanual upper limb activity performance in children with bilateral CP. Recommendation for future measurement studies include familiarisation with the standards required for excellence, which include adequate sample size and content validity studies for PROMs.

External validity of the Both Hands Assessment for evaluating bimanual performance in children with bilateral cerebral palsy

“…6 A recent systematic review identified the BoHA as the only available observation-based instrument assessing bimanual performance in children with bilateral CP. 4 Very high interrater reliability has been reported for the BoHA, while test-retest reliability and responsiveness to change have not yet been established. 7 In addition to scale measurement properties and reliability indices, it is important to investigate the external validity of the BoHA.…”

“…3 One of the recommended outcome measures for evaluating hand function in children with bilateral CP is the newly developed Both Hands Assessment (BoHA). 4 The BoHA scale has been validated through Rasch analyses for children with bilateral CP classified in Manual Ability Classification System (MACS) levels I to III, aged between 18 months and 12 years. 5 The purpose of the BoHA is to measure and describe how effectively both hands are used in playful bimanual activities, as well as describing the degree of side difference between hands.…”

“…One of the recommended outcome measures for evaluating hand function in children with bilateral CP is the newly developed Both Hands Assessment (BoHA) 4 . The BoHA scale has been validated through Rasch analyses for children with bilateral CP classified in Manual Ability Classification System (MACS) levels I to III, aged between 18 months and 12 years 5 .…”

Effect of Combined Therapy of Virtual Reality and Transcranial Direct Current Stimulation in Children and Adolescents With Cerebral Palsy: A Study Protocol for a Triple-Blinded Randomized Controlled Crossover Trial

“…The ACTIVLIM-CP is a questionnaire for parents that measures the performance of global activity in daily activities. It has been validated for children with CP ( 46 – 48 ).…”

Çocuk Kol Rehabilitasyon Ölçeği’nin Türkçe geçerlik ve güvenirliği

“…Bu nedenle, fonksiyonellikle ilgili değerlendirmeler genellikle iki üst ekstremiteyi içerir. 13 Bu yönden bakıldığında, El Becerileri Sınıflandırma Sistemi (EBSS) ve Elle İlgili Yetenek Ölçeği (EİYÖ-Çocuk) bilateral etkilenimi değerlendiren, hem SP'li çocuklarda hem de farklı popülasyonda sıklıkla kullanılan ölçekler olarak karşımıza çıkmaktadır. Fakat, EBSS'nin bir sınıflandırma aracı olması ve Türkçe geçerlik ve güvenirliği çalışılmış olan EİYÖ-Çocuk ölçeğinin bu amaçla kullanılan ve psikometrik olarak en objektif ölçüm yöntemi olduğu vurgulanmakla birlikte, EİYÖ-Çocuk ölçeğinin duyarlılığı konusunda da yeterli kanıtın olmadığı belirtilmektedir.…”