Brazilian Version of the Shriners Hospital Upper Extremity Evaluation (Shuee): Translation, Cultural Adaptation, and Evaluation of Psychometric Properties

Abstract

Objective: To validate the upper limb assessments tool, Shriners Hospital Upper Extremity Evaluation (SHUEE), for individuals with hemiplegic cerebral palsy in the Brazilian population. Methods: Validation study to translate and culturally adapt the Manual and the instrument. The psychometric properties evaluated were reliability and convergent validity. Reliability was determined by internal consistency (Cronbach’s α coefficient), ceiling and floor effect, sensitivity to changes, and intra- and interobserver agreement. Convergent validity was performed using the Pediatric Motor Activity Log, the self-care scale of the Pediatric Evaluation of Disability Inventory, and the Manual Ability Classification System. Results: We evaluated 21 individuals with hemiplegic cerebral palsy, with a mean age of 8.7±4.0 years. After the instrument was translated, there was no need for cultural adaptation. The total Cronbach’s α coefficient was 0.887 (95% confidence interval [95%CI] 0.745-0.970). We calculated sensitivity to changes in five subjects who underwent treatment with Botulinum Toxin Type A and physical therapy, with a significant difference between pre- and post-treatment evaluations in the Spontaneous Functional Analysis and Dynamic Positional Analysis. Convergent validity showed a significant correlation of the Spontaneous Functional Analysis and Dynamic Positional Analysis with the scales evaluated. All items of SHUEE presented high intra- and interobserver agreement. Conclusions: The results revealed that the Brazilian version of the SHUEE demonstrated good reliability and convergent validity, suggesting that it is an adequate and reliable tool for individuals with hemiplegic cerebral palsy in the Brazilian population.

Can the Shriners Hospital Upper Extremity Evaluation (SHUEE) Detect Change in Dynamic Position and Spontaneous Function of the Upper Limb in People With Hemiplegic Cerebral Palsy?

“…8 Multiple researchers have examined these interventions in people with CP and found significant improvements in SHUEE SFA score as well as several other motor activity measures. [6][7][8][20][21][22][23] For people with hemiplegic CP, CIMT is a thoroughly studied noninvasive intervention that, in short-term regimens, achieves statistically significant improvements.…”

“…Other interventions, such as CIMT and hand-arm bimanual intensive training, are intended to improve use of the affected limb and are quickly becoming standard therapy care in people with hemiplegic CP 8. Multiple researchers have examined these interventions in people with CP and found significant improvements in SHUEE SFA score as well as several other motor activity measures 6–8,20–23. For people with hemiplegic CP, CIMT is a thoroughly studied noninvasive intervention that, in short-term regimens, achieves statistically significant improvements.…”